Individual provider Active NPI

Leonel Torres, DDS,MAGD

  • Dentist
  • Deland, FL
National Provider Identifier
1942411962
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN12417 Issued in FL
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
009838000MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170404002590 FL Order and Referring Only - Oral SurgeryPractitioner - General PracticePractitioner - 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

Verify at the official NPI Registry.