Individual provider Active NPI

Victoria Lynn Leonhart, D.D.S.

  • Dentist
  • Boerne, TX
National Provider Identifier
1619030301
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28846 Issued in TX
Practice address
11345 Alamo Ranch Pkwy
Ste 104
Boerne, TX 78006
Phone
(210) 289-1431
NPI assigned
Dec 18, 2006
Last updated
Mar 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28846 TX Primary

Addresses

Primary practice location

11345 Alamo Ranch Pkwy
Ste 104
Boerne, TX 78006

Mailing address

11345 Alamo Ranch Pkwy
Ste 104
Boerne, TX 78006
Phone (210) 289-1431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150521000334 TX Order and Referring Only - DentistPractitioner - Dentist 3779803416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28846TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1619030301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11345 ALAMO RANCH PKWY",
            "address_2": "STE 104",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "78006",
            "telephone_number": "210-289-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11345 ALAMO RANCH PKWY",
            "address_2": "STE 104",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "78006",
            "telephone_number": "210-289-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONHART",
        "first_name": "VICTORIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.