Individual provider Active NPI

Gregory Blair Leifer, DDS

  • General Practice Dentistry
  • Rocky River, OH
National Provider Identifier
1609905405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16821 Issued in OH
Practice address
21851 Center Ridge Road #598
Rocky River, OH 44116-3901
Phone
(440) 331-5730
Fax
(440) 331-5726
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16821 OH Primary

Addresses

Primary practice location

21851 Center Ridge Road #598
Rocky River, OH 44116-3901

Mailing address

21851 Center Ridge Road #598
Rocky River, OH 44116-3901
Phone (440) 331-5730

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
16821OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609905405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21851 CENTER RIDGE ROAD #598",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163901",
            "telephone_number": "440-331-5730",
            "fax_number": "440-331-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21851 CENTER RIDGE ROAD #598",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163901",
            "telephone_number": "440-331-5730",
            "fax_number": "440-331-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIFER",
        "first_name": "GREGORY",
        "middle_name": "BLAIR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "16821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.