Individual provider Active NPI

Alison Stephanie Leecock, DMD

  • General Practice Dentistry
  • Westfield, MA
National Provider Identifier
1659950236
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1859389 Issued in MA
Practice address
79 Broad St
Westfield, MA 01085-2999
Phone
(413) 562-5494
Fax
(413) 568-5597
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 1859389 MA Primary

Addresses

Primary practice location

79 Broad St
Westfield, MA 01085-2999

Mailing address

2 Ridge Rd
Palmer, MA 01069-2259
Phone (413) 636-8612

Other practice location 1

714 Tiverton Ave
Los Angeles, CA 90095-8361
Phone (310) 825-9295

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
1859389MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan M. Kasperowski DMD LLC General Practice PastSince Jun 12, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1659950236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RIDGE RD",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010692259",
            "telephone_number": "413-636-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BROAD ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010852999",
            "telephone_number": "413-562-5494",
            "fax_number": "413-568-5597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 Tiverton Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958361",
            "country_code": "US",
            "telephone_number": "310-825-9295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEECOCK",
        "first_name": "ALISON",
        "middle_name": "STEPHANIE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "1859389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.