Leslie Jean Davis-Groom

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11819 Issued in MD

Practice address

5859 Allentown Way
Temple Hills, MD 20748-2613

Phone

(301) 615-0940

NPI assigned

Jul 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1639723935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 E CEDAR ST",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207855217",
            "telephone_number": "301-377-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 ALLENTOWN WAY",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207482613",
            "telephone_number": "301-615-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-GROOM",
        "first_name": "LESLIE",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leslie.groom@cc-dc.org",
            "affiliation": "N",
            "address_1": "5859 Allentown Way",
            "city": "Temple Hills",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207482613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eugene Crim Jr.
• Gina Mekeale Crump, CNA, CMT,
• Nicole Sharron Danson
• Jemila Darku
• Barbara Naadu Davies-Pugh, LPTA
• Andrea Wair Davis
• Derricka A Davis
• Kimberly A Davis, LPC
• Raphael Joshua Denbow II, PT
• Doris Denmon

• General Practice Dentistry in Temple Hills, MD
• Providers in Temple Hills, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.