Active NPI
William Benjamin Leibow, D.D.S.
- Endodontics
- Phoenix, AZ
National Provider Identifier
1417954074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 2006
- Practice address
- 4910 N 44TH St
Ste 10
Phoenix, AZ 85018-2726 - Phone
- (602) 840-3636
- NPI assigned
- Jun 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 2006 | AZ | Primary |
Addresses
Primary practice location
4910 N 44TH St
Ste 10
Phoenix, AZ 85018-2726
Mailing address
5516 N Camelback Canyon Dr
Phoenix, AZ 85018-1239
Phone (602) 840-8433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160404001964 | TX | Order and Referring Only - Oral Surgery | 1456656636 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006 | AZ | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| I Robert Matloff DDS Ms LTD | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Endodontics
- Phoenix, AZ
- NPI 1033275391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417954074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5516 N CAMELBACK CANYON DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850181239",
"telephone_number": "602-840-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4910 N 44TH ST",
"address_2": "STE 10",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850182726",
"telephone_number": "602-840-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIBOW",
"first_name": "WILLIAM",
"middle_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "AZ",
"license": "2006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.