Individual provider Active NPI

Lindsay Leland, DMD

  • Dentist
  • Long Beach, CA
National Provider Identifier
1639223092
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56897 Issued in CA
Practice address
3960 Atlantic Ave Ste 105-B
Long Beach, CA 90807-3502
Phone
(562) 988-0148
Fax
(678) 990-0359
NPI assigned
Jan 23, 2007
Last updated
Nov 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56897 CA Primary
General Practice Dentistry 1223G0001X DN013333 GA

Addresses

Primary practice location

3960 Atlantic Ave Ste 105-B
Long Beach, CA 90807-3502

Mailing address

3960 Atlantic Ave
Long Beach, CA 90807-3502
Phone (562) 988-0148

Other practice location 1

2700 Marine Ave Ste 105
Redondo Beach, CA 90278-1124
Phone (310) 675-7768

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
DN013333GAMDGeneral Practice Dentistry
56897CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Imagix 2 Dental Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1639223092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073502",
            "telephone_number": "562-988-0148",
            "fax_number": "678-990-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 ATLANTIC AVE STE 105-B",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073502",
            "telephone_number": "562-988-0148",
            "fax_number": "678-990-0359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Marine Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Redondo Beach",
            "state": "CA",
            "postal_code": "902781124",
            "country_code": "US",
            "telephone_number": "310-675-7768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LELAND",
        "first_name": "LINDSAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56897",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.