DR. JERRY WAYNE LEONARD SR. (NPI# 1578678983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578678983 |
| Entity Type | Individual |
| Full Name | DR. JERRY WAYNE LEONARD SR. |
| Credential | D.MD. |
| Practice Address |
10011 Se Division St 204 Portland OR 97266-1351 |
| Practice Telephone | 5032535741 |
| Mailing Telephone | 5032535741 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
OR5193 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104910694 | Jerry Lee Leonard | Dentist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2006-10-02 |
| Street Address |
10011 SE DIVISION ST 204 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97266-1351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811342710 | Kristen S Miller | Psychologist | 10011 Se Division St, #203, Portland, OR 97266-1351 | 2016-04-28 |
| 1760837801 | Maria Mitchell | Counselor | 10011 Se Division St, #305, Portland, OR 97266-1351 | 2016-04-26 |
| 1659725620 | Carson Bortz | Counselor | 10011 Se Division St, #305, Portland, OR 97266-1351 | 2016-04-15 |
| 1659748507 | Heather Anne Tollander | Psychologist | 10011 Se Division St, Suite 203, Portland, OR 97266-1351 | 2015-08-26 |
| 1457727828 | Matthew M Block | Counselor | 10011 Se Division St, Suite 203, Portland, OR 97266-1351 | 2015-08-19 |
| 1720454689 | Tess O'neil Mcshane | Counselor | 10011 Se Division St, Suite #305, Portland, OR 97266-1351 | 2015-08-14 |
| 1699159293 | Elizabeth Kraemer | Case Manager/Care Coordinator | 10011 Se Division St, Portland, OR 97266-1351 | 2015-07-13 |
| 1003294323 | Elizabeth Gordon | Counselor | 10011 Se Division St, Ste 305, Portland, OR 97266-1351 | 2015-05-07 |
| 1356746101 | Mirna Pani | Counselor | 10011 Se Division St, #305, Portland, OR 97266-1351 | 2014-10-22 |
| 1548678154 | R. Nathaniel Wilson-traisman | Counselor | 10011 Se Division St, Suite #305, Portland, OR 97266-1351 | 2014-07-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1992204697 | Sober Living Oregon Treatment Center | Clinic/Center | 10209 Se Division, Portland, OR 97266 | 2018-02-08 |
| 1699204024 | Malori Christine Butler | Registered Nurse | 7335 Se 85th Ave., Portland, OR 97266 | 2017-06-08 |
| 1487028882 | Emil Kunkel | Naturopath | 6318 Se 87th Ave, Portland, OR 97266 | 2015-11-23 |
| 1194195313 | Cory Hall-martin | Counselor | 10011 Se Division St #305, Portland, OR 97266 | 2015-09-30 |
| 1336517721 | Krispin Mayfield | Counselor | 10011 Se Division St., Suite 203, Portland, OR 97266 | 2015-09-02 |
| 1407247927 | Syrena Nicholson | Community Health Worker | 7721 Se 92nd Avenue, Apt K, Portland, OR 97266 | 2015-02-06 |
| 1659777886 | Berhanu Aynalem Mekbib | Adult Companion | 9125 Sw 55th, El Dorado, Portland, OR 97266 | 2014-11-17 |
| 1871930685 | Felicitas Amelia Penaloza | Behavioral Analyst | 9911 Se Mt.scott Boulevard, Portland, OR 97266 | 2013-06-03 |
| 1710237326 | Janna Renee Higgins | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, OR 97266 | 2012-09-12 |
| Find all providers in zip 97266 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097034 | Hannah Glazunov | Dentist | 4970 S Landing Dr Unit 302, Portland, OR 97239-5900 | 2020-09-13 |
| 1093345159 | Ashley Bennett Dds, LLC | Dentist | 5415 Sw Westgate Dr Ste 202, Portland, OR 97221-2429 | 2020-01-17 |
| 1841844354 | Carly K Christoferson | Dentist | 1616 Sw Sunset Blvd Ste A, Portland, OR 97239-2641 | 2019-08-01 |
| 1083279384 | Timber Dental Downtown LLC | Dentist | 310 Sw 4th Ave Ste 100, Portland, OR 97204-2345 | 2019-05-02 |
| 1780140715 | Timber Dental East Burnside | Dentist | 1200 Se Sandy Blvd, Portland, OR 97214-1347 | 2019-02-14 |
| 1548726581 | Timber Dental Bethany | Dentist | 15715 Nw Central Dr Ste 7-8, Portland, OR 97229-1267 | 2019-02-14 |
| 1124583208 | Portland Dental LLC | Dentist | 511 Sw 10th Ave Ste 1206, Portland, OR 97205-2713 | 2019-02-04 |
| 1245701465 | Jeffrey Levitt Brady | Dentist | 10060 E Burnside St, Portland, OR 97216-2334 | 2018-12-16 |
| 1780166918 | Daniel Alejandro Mesa | Dentist | 2038 Lloyd Ctr # H317, Portland, OR 97232-1309 | 2018-09-04 |
| 1093293375 | Trusha B Patel | Dentist | 3801 N Interstate Ave, Portland, OR 97227-1109 | 2018-07-30 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.