Dr Leandre Daniel Gervais, DDS is a
Student In An Organized Health Care Education/training Program based in Charlotte, North Carolina. Dr Leandre Daniel Gervais is licensed to practice in Georgia (license number DN12399) and his current practice location is
1000 Blythe Blvd, Charlotte, North Carolina. He can be reached at his office (for appointments etc.) via phone at
(704) 355-2165.
NPI number for Dr Leandre Daniel Gervais is 1184315152 and his current mailing address is 1000 Blythe Blvd, Charlotte, Atlanta, North Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1184315152.
Healthcare Provider's Profile
| Full Name | Dr Leandre Daniel Gervais |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1000 Blythe Blvd, Charlotte, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1184315152
- Provider Enumeration Date: 05/18/2023
- Last Update Date: 05/23/2025
Medical Identifiers
Medical identifiers for Dr Leandre Daniel Gervais such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184315152 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | DN123399 (Georgia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | DN12399 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Leandre Daniel Gervais is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Leandre Daniel Gervais, DDS
1000 Blythe Blvd, Charlotte,
Atlanta, NC 28203-5812
Ph: (704) 355-2165 | Dr Leandre Daniel Gervais, DDS
1000 Blythe Blvd,
Charlotte, NC 28203-5812
Ph: (704) 355-2165 |
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