Raymond Leo General, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

031450-L Issued in PA

Practice address

504 W Penn St
Selinsgrove, PA 17870-1644

Phone

(570) 374-4625

Fax

(570) 374-0052

NPI assigned

Dec 13, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Selinsgrove Dental Arts

  • Dentist
  • Selinsgrove, PA
  • NPI 1134347933
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811058787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178700265",
            "telephone_number": "570-374-4625",
            "fax_number": "570-374-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W PENN ST",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178701644",
            "telephone_number": "570-374-4625",
            "fax_number": "570-374-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENERAL",
        "first_name": "RAYMOND",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "031450-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "031450-L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geisinger Clinic Selinsgrove
• Geisinger Medical Center
• Geisinger Medical Oncology Selinsgrove
• Gerald David Geist Jr., O.D.
• Gene N Brosius Behavior Analysis Counseling
• Gerald Geist
• Kenneth R Gift, OD
• Erin Lea Goedegebuure, MA, LPC
• Alyson Nicole Golden, MAT, LAT, ATC
• Jagdeep Goraya, DMD

• Dentist in Selinsgrove, PA
• Providers in Selinsgrove, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.