Individual provider Active NPI

Joshua L Leal, D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Harrison, AR
National Provider Identifier
1487829420
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
3396 Issued in AR
Practice address
520 N Pine St
Harrison, AR 72601-3442
Phone
(870) 741-3877
Fax
(870) 741-2406
NPI assigned
Apr 29, 2008
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN18572 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 019.026579 IL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3396 AR
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 3396 AR Primary

Addresses

Primary practice location

520 N Pine St
Harrison, AR 72601-3442

Mailing address

PO Box 4185
Fayetteville, AR 72702-4185
Phone (870) 741-3877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 1, 2025 through May 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18572FLMDOral and Maxillofacial Surgery (Dentist)
019.026579ILMDOral and Maxillofacial Surgery (Dentist)
3396ARMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral & Facial Surgery Center PA Oral and Maxillofacial Surgery CurrentSince Jan 2, 2022 Accepting new patients
Gmos Oral Surgery, PC Oral and Maxillofacial Surgery PastSince Jan 1, 2024 Accepting new patients

Locations

520 N Pine St
Harrison, AR 72601
Phone (870) 414-4000

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1487829420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4185",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727024185",
            "telephone_number": "870-741-3877",
            "fax_number": "870-741-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PINE ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013442",
            "telephone_number": "870-741-3877",
            "fax_number": "870-741-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAL",
        "first_name": "JOSHUA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18572",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.026579",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "3396",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AR",
            "license": "3396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

Verify at the official NPI Registry.