Wesley James Leichty II, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

54819 Issued in CA

Practice address

1590 N Riverside Ave
Rialto, CA 92376

Phone

(909) 875-2050

Fax

(909) 875-2185

NPI assigned

Sep 4, 2007

Last updated

Nov 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1467646422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 N RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768073",
            "telephone_number": "909-875-2050",
            "fax_number": "909-875-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 N RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "92376",
            "telephone_number": "909-875-2050",
            "fax_number": "909-875-2185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46900 Monroe St Bldg B",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922014827",
            "country_code": "US",
            "telephone_number": "760-396-5733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEICHTY",
        "first_name": "WESLEY",
        "middle_name": "JAMES",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uy Quang Le, PHARMD
• Jaisyn Leak
• Cynthia Leclair, RN, BSN, PHN
• Destiny Selina Lee
• Solomon Sov Lee, PHARM D
• Molly Leja, M.S.
• Edwin Estuardo Lemus, B.A., MPA
• Kariaana Leon
• Crisanto O Leonor, MD
• Stephanie Evette Lewis, CPNP

• Dentist in Rialto, CA
• Providers in Rialto, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.

Verify at the official NPI Registry.