Jacqueline Leah Sadeghian, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

9522 Issued in SC

Practice address

203 N Lake Dr
Lexington, SC 29072

Phone

(678) 244-4871

NPI assigned

Jun 22, 2009

Last updated

May 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline Leah Illuminate Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Practice roles

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.

• Weiss Dental & Orthodontics Professional Corporation

  dba Courtesy Dental & Orthodontics

  • Dentist
  • Henderson, NV
  • NPI 1265495964
  NPD (past)

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1780812313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722833",
            "telephone_number": "254-383-4559",
            "fax_number": "702-456-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "678-244-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADEGHIAN",
        "first_name": "JACQUELINE",
        "middle_name": "LEAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2024-05-08",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9522",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "ILLUMINATE",
            "middle_name": "LEAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Rummel, LISW-CP
• Lindsay Maria Dinallo Rush
• Mary Ruthven
• Angela Sacco, RDH
• Sacred Grove Counseling & Healing Services, LLC
• Safe Place Counseling
• Katrena Amber Saillant, BSN
• Saint Matthews Ambulance Service of the Midlands, LLC (For Life Medical Transport)
• Ella Sofia Salce, OT
• Makeyla Salley, M.A., LAC

• Dentist in Lexington, SC
• Providers in Lexington, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.