Individual provider Active NPI

Thomas M Leiendecker, D.D.S.

  • Public Health Dentistry
  • Bethesda, MD
National Provider Identifier
1528236429
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
5225 Issued in NC
Practice address
4301 Jones Bridge Road (Usu / Tscohs)
Building 141, Room 221
Bethesda, MD 20814-4799
Phone
(301) 319-6973
Fax
(301) 319-6975
NPI assigned
Feb 13, 2008
Last updated
Feb 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 5225 NC Primary

Addresses

Primary practice location

4301 Jones Bridge Road (Usu / Tscohs)
Building 141, Room 221
Bethesda, MD 20814-4799

Mailing address

4301 Jones Bridge Road (Usu / Tscohs)
Building 141, Room 221
Bethesda, MD 20814-4799
Phone (301) 319-6973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5225NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1528236429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 JONES BRIDGE ROAD (USU / TSCOHS)",
            "address_2": "BUILDING 141, ROOM 221",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144799",
            "telephone_number": "301-319-6973",
            "fax_number": "301-319-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 JONES BRIDGE ROAD (USU / TSCOHS)",
            "address_2": "BUILDING 141, ROOM 221",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144799",
            "telephone_number": "301-319-6973",
            "fax_number": "301-319-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIENDECKER",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NC",
            "license": "5225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.