Jeremy D Leland, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

23361 Issued in TX

Practice address

3622 Williams Dr
BLDG 1
Georgetown, TX 78628-2415

Phone

(512) 869-0529

Fax

(512) 498-0154

NPI assigned

Dec 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 15, 2024 through Jan 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1629251624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49500",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787659500",
            "telephone_number": "512-454-1220",
            "fax_number": "512-467-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 WILLIAMS DR",
            "address_2": "BLDG 1",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282415",
            "telephone_number": "512-869-0529",
            "fax_number": "512-498-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LELAND",
        "first_name": "JEREMY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "23361",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britney Lee, PTA
• Caitlin Lee, M.ED.
• Jacqueline Lee
• Daniel James Leeman, M.D.
• Legend Dental-Georgetown (Legend Dental & Orthodontics)
• Anjanette Arlene Lelko, PHARM D, RN
• Allison Rebecca Lemone
• Kristie Lee Lensing, LPC
• Leon Psychiatric Services PLLC
• Jennifer Lesniewski, O.D

• Oral and Maxillofacial Surgery (Dentist) in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.