Active NPI
Leon Bass, DMD
- Dentist
- Jamaica, NY
National Provider Identifier
1720100837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 050924
- Practice address
- 18622 Avon Rd
Jamaica, NY 11432-5823 - Phone
- (917) 892-3628
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 050924 | NY | Primary |
Addresses
Primary practice location
18622 Avon Rd
Jamaica, NY 11432-5823
Mailing address
18622 Avon Rd
Jamaica, NY 11432-5823
Phone (917) 892-3628
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
| License | State | Type | Specialty |
|---|---|---|---|
| 050924 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1720100837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18622 AVON RD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114325823",
"telephone_number": "917-892-3628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18622 AVON RD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114325823",
"telephone_number": "917-892-3628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASS",
"first_name": "LEON",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "050924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.