Edgardo A Leiva Cardona, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN28269 Issued in FL

Practice address

2000 S Patrick Dr Ste 1
Indian Harbour Beach, FL 32937-4462

Phone

(321) 773-1000

NPI assigned

Jul 3, 2023

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)

Not enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• CDPG, P.L.

  dba Christie Dental of Indian Harbour Beach

  • General Practice Dentistry
  • Indian Harbour Beach, FL
  • NPI 1639830490
  NPD

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1447937107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 3RD AVE APT B",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033143",
            "telephone_number": "305-778-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S PATRICK DR STE 1",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374462",
            "telephone_number": "321-773-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIVA CARDONA",
        "first_name": "EDGARDO",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Corrigan Lang, DDS, MD, PHD
• Laylah Lara, PTA
• Leann J Mandese OD PA
• Mary Lebeau
• Julia Ann Lee
• Lisa L Cummings, DPM, P.a.
• Live Well Counseling, LLC
• Kimberley Nicole Longmire, LACTATION COUNSELOR
• Erica Lopez
• Glenn Losasso, D.D.S

• Dentist in Indian Harbour Beach, FL
• Providers in Indian Harbour Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.