Leonel Venton Dickey, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28538 Issued in CA

Practice address

1845 Fillmore St
San Francisco, CA 94115-3125

Phone

(415) 567-2600

Fax

(415) 567-2601

NPI assigned

Nov 22, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1487729729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 FILLMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 FILLMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153125",
            "telephone_number": "415-567-2600",
            "fax_number": "415-567-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "LEONEL",
        "middle_name": "VENTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B28538",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Dickey, PHD
• David Grayson Dickey
• Emily Joyce Dickey, MD
• Kalsang Dickey
• Larry Laverne Dickey, MD
• Lillie Bea Dickey
• Jon Dickinson, M.D.
• Olivia Dickinson
• William A. Dickman, M.D.
• Christine E Dickson, PHD

• General Practice Dentistry in San Francisco, CA
• Providers in San Francisco, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.