Peter Leone, DDS MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901015827 Issued in MI

Practice address

30140 Harper Ave
Suite 200
Saint Clair Shores, MI 48082

Phone

(586) 285-9888

Fax

(586) 285-9898

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679662860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30140 HARPER AVE",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48082",
            "telephone_number": "586-285-9888",
            "fax_number": "586-285-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30140 HARPER AVE",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48082",
            "telephone_number": "586-285-9888",
            "fax_number": "586-285-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONE",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901015827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lauren Marie Letzmann
• John Andrew Leverenz, DDS
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• Kelly A Lewis, FNP

• Periodontics in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.