Individual provider Active NPI

Bruce Lein, DDS

  • General Practice Dentistry
  • Jupiter, FL
National Provider Identifier
1902920598
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 17633 Issued in FL
Practice address
825 US Highway 1
Jupiter, FL 33477-5976
Phone
(561) 744-6121
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 17633 FL Primary

Addresses

Primary practice location

825 US Highway 1
Jupiter, FL 33477-5976

Mailing address

825 S US Highway 1
Ste 250
Jupiter, FL 33477-5193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160607001824 FL Order and Referring Only - DentistPractitioner - Dentist 7618267402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 17633FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1902920598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S US HIGHWAY 1",
            "address_2": "STE 250",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 US HIGHWAY 1",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775976",
            "telephone_number": "561-744-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIN",
        "first_name": "BRUCE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 17633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.