Timothy Leetrakul

Primary specialty

DentistTaxonomy code 122300000X

License

58017 Issued in CA

Practice address

12643 Sherman Way Ste D
North Hollywood, CA 91605-5271

Phone

(818) 765-3534

Fax

(818) 765-3534

NPI assigned

Apr 24, 2009

Last updated

Apr 24, 2009By the provider in NPPES

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 CA

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

Locations

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

• Timothy Leetrakul DDS Dental Corporation

  • General Practice Dentistry
  • North Hollywood, CA
  • NPI 1699177642
  NPD Authorized official

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1932343647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12643 SHERMAN WAY STE D",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055271",
            "telephone_number": "818-765-3534",
            "fax_number": "818-765-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12643 SHERMAN WAY STE D",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055271",
            "telephone_number": "818-765-3534",
            "fax_number": "818-765-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEETRAKUL",
        "first_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Lee, D.D.S.
• Pei F Lee, L.AC
• Samuel B Lee, M.D.
• Shannen Boyoung Lee
• Wonil Lee, M.D.
• Maria Teresa Legaspi
• Legend Health Care
• Amy Lehr
• Lending Hand Medical Transportation
• Leo Home Health Inc

• Dentist in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; 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.