Walter L Leeks III, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 13122 Issued in GA

Practice address

4376 Lawrenceville Rd
Loganville, GA 30052

Phone

(770) 466-0363

NPI assigned

May 22, 2007

Last updated

Dec 13, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 GA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: walter.leeks@oakhurst.gadirect.net

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.

• Medcura Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Stone Mountain, GA
  • NPI 1417011487
  Medicare reassignment NPD
• Medcura Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1811761448
  NPD
• Medcura Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Decatur, GA
  • NPI 1245010347
  NPD (past)
• Medcura Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Conyers, GA
  • NPI 1811333859
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1801006754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4376 LAWRENCEVILLE RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "30052",
            "telephone_number": "770-466-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4376 LAWRENCEVILLE RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "30052",
            "telephone_number": "770-466-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEKS",
        "first_name": "WALTER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN 13122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey Lynn Lapointe, RD
• Theodore Garrett Larew
• Laura C Davis DDS
• James Le, PHARM.D
• Amanda Frances Lee, AGNP
• Bianca Leon
• Brittney Nicole Lewis, NCC
• Ellen Lewis, APRN
• Tilina Lewis, CNA, PCT
• Life Enrichment and Wellness Services

• General Practice Dentistry in Loganville, GA
• Providers in Loganville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.