BRYCE D LEAVITT DMD MD NPI 1093919417

NPI Information

  • NPI: 1093919417
  • Provider Name: BRYCE D LEAVITT, DMD, MD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 670 S GREEN VALLEY PKWY #15
    HENDERSON, NV
    ZIP 89052
  • Phone: (702) 685-3700

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NPI Details

Bryce D Leavitt, DMD, MD is an oral and maxillofacial surgery dentist in Henderson, NV with 19 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Bryce D Leavitt, DMD, MD NPI is 1093919417. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OREGON HEALTH & SCIENCES UNIV SCHOOL OF DENTISTRY
Graduation Year:2007

The provider's business location address is:

670 S GREEN VALLEY PKWY #15
HENDERSON, NV
ZIP 89052
Phone: (702) 685-3700
Fax: (702) 685-3701

The NPI 1093919417 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)

The enumeration date for this NPI number is 6/11/2007 and was last updated on 3/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204E00000XOral & Maxillofacial SurgeryD12476MINNESOTANo
21223S0112XDentistOral and Maxillofacial SurgerySZ-127NEVADAYes
31223S0112XDentistOral and Maxillofacial Surgery6227NEVADANo
4204E00000XOral & Maxillofacial Surgery55354MINNESOTANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1884127000MEDICAIDMINNESOTA
233826800MEDICAIDWISCONSIN
3ENROLLEDMEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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