Active NPI
Iva Leroy, DDS
- Pediatric Dentistry
- West Orange, NJ
National Provider Identifier
1528350642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22DI02569800
- Practice address
- 412 Pleasant Valley Way
West Orange, NJ 07052-2988 - Phone
- (646) 717-3573
- NPI assigned
- May 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 22DI02569800 | NJ | Primary |
Addresses
Primary practice location
412 Pleasant Valley Way
West Orange, NJ 07052-2988
Mailing address
34 Lorraine St
Glen Ridge, NJ 07028-2028
Phone (646) 717-3573
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02569800 | NJ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525651200000",
"number": "1528350642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 LORRAINE ST",
"city": "GLEN RIDGE",
"state": "NJ",
"postal_code": "070282028",
"telephone_number": "646-717-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 PLEASANT VALLEY WAY",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522988",
"telephone_number": "646-717-3573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEROY",
"first_name": "IVA",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-08",
"last_updated": "2018-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI02569800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.