Alden Marvin Leib, D.D.S.,M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

008253 Issued in MI

Practice address

24924 Michigan Ave
Dearborn, MI 48124-1740

Phone

(313) 274-8522

Fax

(313) 274-5396

NPI assigned

Oct 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00414

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1326725524
  NPD (past)
• Periodontic PLLC

  • Periodontics
  • Wyandotte, MI
  • NPI 1205014669
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407939762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24924 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241740",
            "telephone_number": "313-274-8522",
            "fax_number": "313-274-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24924 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241740",
            "telephone_number": "313-274-8522",
            "fax_number": "313-274-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIB",
        "first_name": "ALDEN",
        "middle_name": "MARVIN",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "008253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Nicole Lee
• Valencia Maire Lee
• Ashton Leftridge
• Legacy Medical Transportation
• Nailah D Leggett
• Haley Elizabeth Leleniewski
• Kyleigh-Jo Marie Lemerande
• Joseph Lempicki, LLP
• Konia M Lenear, HIGH SCHOOL
• Keara Michelle Lenoir

• Periodontics in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.