Individual provider Active NPI

Deanna Ellene Lecroix, D.D.S.

  • General Practice Dentistry
  • Maineville, OH
National Provider Identifier
1568046092
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30026456 Issued in OH
Practice address
3116 Montgomery Road
Unit 1
Maineville, OH 45039
Phone
(513) 334-4060
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30026456 OH Primary

Addresses

Primary practice location

3116 Montgomery Road
Unit 1
Maineville, OH 45039

Mailing address

35 E Kemper Rd
Cincinnati, OH 45246-3224
Phone (513) 642-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220623000898 KY Order and Referring Only - DentistPractitioner - Dentist 2567841430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30026456OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1568046092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E KEMPER RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463224",
            "telephone_number": "513-642-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 MONTGOMERY ROAD",
            "address_2": "UNIT 1",
            "city": "MAINEVILLE",
            "state": "OH",
            "postal_code": "45039",
            "telephone_number": "513-334-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECROIX",
        "first_name": "DEANNA",
        "middle_name": "ELLENE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2023-08-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30026456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maineville, OH

Sources for this page

Verify at the official NPI Registry.