Individual provider Active NPI

Brett Alan Leemaster, DDS

  • General Practice Dentistry
  • Moore, OK
National Provider Identifier
1467655068
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5972 Issued in OK
Practice address
520 S Telephone Rd Ste 205
Moore, OK 73160-5425
Phone
(405) 793-8300
Fax
(405) 793-8397
NPI assigned
Jun 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5972 OK Primary

Addresses

Primary practice location

520 S Telephone Rd Ste 205
Moore, OK 73160-5425

Mailing address

4504 SE 27TH St
Del City, OK 73115-4126
Phone (405) 410-3040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20160705000527 OK Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6204128770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5972OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Solutions, PLLC PastSince Jan 1, 2013 Accepting new patients
Larry D. Leemaster D.D.S., P.C. General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467655068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 SE 27TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731154126",
            "telephone_number": "405-410-3040",
            "fax_number": "405-793-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S TELEPHONE RD STE 205",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605425",
            "telephone_number": "405-793-8300",
            "fax_number": "405-793-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEMASTER",
        "first_name": "BRETT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.