Active NPI
Leonard Bryan Gerken, DMD
- General Practice Dentistry
- Oro Valley, AZ
National Provider Identifier
1477554483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D008361
- Practice address
- 10509 N Oracle Rd
Suite 141
Oro Valley, AZ 85737-9375 - Phone
- (520) 498-0500
- NPI assigned
- Aug 2, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D 6829 | OR | |
| General Practice Dentistry | 1223G0001X | D008361 | AZ | Primary |
Addresses
Primary practice location
10509 N Oracle Rd
Suite 141
Oro Valley, AZ 85737-9375
Mailing address
10509N Oracle Rd 141
Oro Valley, AZ 85737-9381
Phone (520) 498-0500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- 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 |
|---|---|---|---|---|
| I20151229001640 | AZ | Order and Referring Only - Dentist | 4082915558 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D 6829 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Schmidtke Dental Northwest PLC | Past | Accepting new patients | |
| 537 W Wetmore Dental Inc | 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 and National Provider Directory roles.
-
- Dentist
- Tucson, AZ
- NPI 1467985622
-
- Dentist
- Oro Valley, AZ
- NPI 1659432425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450396800000",
"number": "1477554483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10509N ORACLE RD 141",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857379381",
"telephone_number": "520-498-0500",
"fax_number": "520-498-0504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10509 N ORACLE RD",
"address_2": "SUITE 141",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857379375",
"telephone_number": "520-498-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERKEN",
"first_name": "LEONARD",
"middle_name": "BRYAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2015-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D 6829",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D008361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oro Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.