Active NPI
Leonel Torres, DDS,MAGD
- Dentist
- Deland, FL
National Provider Identifier
1942411962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN12417
- Practice address
- 1205 S Woodland Blvd Ste 5
Deland, FL 32720-7464 - Phone
- (386) 888-4911
- Fax
- (386) 269-9951
- NPI assigned
- May 24, 2007
- Last updated
- Jul 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN12417 | FL | Primary |
Addresses
Primary practice location
1205 S Woodland Blvd Ste 5
Deland, FL 32720-7464
Mailing address
1205 S Woodland Blvd Ste 3
Deland, FL 32720-7464
Phone (862) 026-0253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009838000 | Medicaid | FL |
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170404002590 | FL | Order and Referring Only - Oral Surgery | 4183900244 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1942411962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 S WOODLAND BLVD STE 3",
"city": "DELAND",
"state": "FL",
"postal_code": "327207464",
"telephone_number": "862-026-0253",
"fax_number": "386-202-1755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 S WOODLAND BLVD STE 5",
"city": "DELAND",
"state": "FL",
"postal_code": "327207464",
"telephone_number": "386-888-4911",
"fax_number": "386-269-9951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TORRES",
"first_name": "LEONEL",
"credential": "DDS,MAGD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN12417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009838000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Deland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.