Active NPI
Leah Peres, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cleveland, OH
National Provider Identifier
1841743630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 30.025473
- Practice address
- 16909 Chagrin Blvd
Cleveland, OH 44120-3725 - Phone
- (216) 862-0544
- NPI assigned
- Jul 27, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 30.025473 | OH | Primary |
Addresses
Primary practice location
16909 Chagrin Blvd
Cleveland, OH 44120-3725
Mailing address
16909 Chagrin Blvd
Cleveland, OH 44120-3725
Phone (216) 862-0544
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841743630 | Medicaid | NY |
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 |
|---|---|---|---|
| 30.025473 | OH | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542326400000",
"number": "1841743630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16909 CHAGRIN BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441203725",
"telephone_number": "216-862-0544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16909 CHAGRIN BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441203725",
"telephone_number": "216-862-0544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERES",
"first_name": "LEAH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-27",
"last_updated": "2018-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "OH",
"license": "30.025473",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1841743630",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.