Jeremiah Leary, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

D9576 Issued in OR

Practice address

5440 SW Westgate Dr Ste 165
Portland, OR 97221-2421

Phone

(503) 297-1471

NPI assigned

Apr 19, 2011

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 OR

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 and National Provider Directory roles.

• Advantage Dental Group, PC

  • General Practice Dentistry
  • Bend, OR
  • NPI 1972970671
  NPD (past)

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891086229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR STE 165",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212421",
            "telephone_number": "503-297-1471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10535 NE Glisan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972204077",
            "country_code": "US",
            "telephone_number": "503-444-2824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEARY",
        "first_name": "JEREMIAH",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathleen Lear, PHD
• Kevin Learfield
• Claire K Learmonth, MD
• Scott Arthur Learn
• Jessica Learned
• Nolan Lease
• Amy Eiko Bernel Leatherwood, N.P.
• Elizabeth Leavell
• Yaowaree Leavell, MD
• Kareen Leavens, PA-C

• Dentist in Portland, OR
• Providers in Portland, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.