Individual provider Active NPI

Leslie Jane Paris, D.D.S.,M.S.D.

  • Periodontics
  • Fort Collins, CO
National Provider Identifier
1902179963
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6999 Issued in CO
Practice address
4033 Boardwalk Dr Unit 100
Fort Collins, CO 80525-5937
Phone
(970) 207-4061
Fax
(970) 207-0051
NPI assigned
Feb 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6999 CO Primary

Addresses

Primary practice location

4033 Boardwalk Dr Unit 100
Fort Collins, CO 80525-5937

Mailing address

4033 Boardwalk Dr Unit 100
Fort Collins, CO 80525-5937
Phone (970) 207-4061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20140822001334 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214155894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Colorado Periodontics Periodontics Past Accepting new patients
Leslie J. Paris, D.D.S.,M.S.D.,P.C. Periodontics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1902179963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 BOARDWALK DR UNIT 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255937",
            "telephone_number": "970-207-4061",
            "fax_number": "970-207-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 BOARDWALK DR UNIT 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255937",
            "telephone_number": "970-207-4061",
            "fax_number": "970-207-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARIS",
        "first_name": "LESLIE",
        "middle_name": "JANE",
        "credential": "D.D.S.,M.S.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "6999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.