Individual provider Active NPI

Leilah Baisden, DDS

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1700248523
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36046 Issued in TX
Practice address
19961 Katy Fwy
Houston, TX 77094-1019
Phone
(713) 244-7799
NPI assigned
Mar 22, 2016
Last updated
Aug 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6693 LA
General Practice Dentistry 1223G0001X 36046 TX Primary

Addresses

Primary practice location

19961 Katy Fwy
Houston, TX 77094-1019

Mailing address

2536 Amherst St Ste a
Houston, TX 77005-3207
Phone (713) 490-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20161026000470 LA Order and Referring Only - DentistPractitioner - Dentist 5395023378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36046TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Dental Associates, PA General Practice PastSince Aug 23, 2020 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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1700248523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 AMHERST ST STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770053207",
            "telephone_number": "713-490-8880",
            "fax_number": "713-490-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19961 KATY FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941019",
            "telephone_number": "713-244-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAISDEN",
        "first_name": "LEILAH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6693",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.