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Deactivated NPI 1992701957 Deactivated / Inactive NPI Female Practitioner

Dr. Ellen Brackett Leaf , DDS

Dentist - General Practice • San Mateo, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Ellen Leaf has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 23, 2005
NPI Deactivation Date March 16, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Ellen Leaf, DDS was a registered Dentist - General Practice practicing in San Mateo, CA. Throughout an active medical career spanning 1 years, Dr. Leaf provided care at the practice location at 190 W 25TH AVE until profile deactivation on 2006-03-16.

Practice Location & Contact Primary Location

Practice Address

190 W 25th Ave

San Mateo, CA 944032298

Telephone 6503451991
Fax 6503451307

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in San Mateo, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 2.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
99 Specialists

Practicing in San Mateo, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 32869

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1205180619

Doctor of Chiropractic

NPI 1588787998

Doctor of Chiropractic

NPI 1790039022

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated November 06, 2025

Record deactivated on November 06, 2025

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Updated Practice Location July 08, 2007

Registered at 190 W 25TH AVE, SAN MATEO, CA 944032298 (Tel: 6503451991)

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Updated Business Mailing Address July 08, 2007

Registered at 190 W 25TH AVE, SAN MATEO, CA 944032298 (Tel: 6503451991)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ELLEN LEAF, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #32869 in CA)

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NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 16, 2006

Record deactivated on March 16, 2006

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Initial NPI Registration & Enumeration June 23, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992701957
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 23, 2005
Last Update: July 08, 2007
Deactivation Date: March 16, 2006

Mailing Address

190 W 25th Ave

San Mateo, CA 944032298

Phone: 6503451991

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.