NPIMap

Organization Active NPI

Leah Thompson Gagnon, D.M.D, P.a.

  • Dentist
  • Niceville, FL
National Provider Identifier
1023177094
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 17297 Issued in FL
Legal business name
LEAH THOMPSON GAGNON, D.M.D, P.A.
Practice address
4550 Highway 20 East
Suite C
Niceville, FL 32578
Phone
(850) 897-1100
NPI assigned
Dec 6, 2006
Last updated
Jan 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Dr. Leah Thompson Gagnon, D.M.D.NPI 1235273392
Title
Doctor of Dental Medicine
Phone
(850) 897-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN 17297 FL Primary

Addresses

Primary practice location

4550 Highway 20 East
Suite C
Niceville, FL 32578

Mailing address

4550 Highway 20 East
Suite C
Niceville, FL 32578
Phone (850) 897-1100

Other identifiers 1

IdentifierTypeStateIssuer
1235273392OtherFLNPI TYPE 1

National Provider Directory

National Provider Directory

Locations

4550 E Highway 20
Ste C
Niceville, FL 32578
Phone (850) 897-1100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1023177094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 HIGHWAY 20 EAST",
            "address_2": "SUITE C",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-897-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 HIGHWAY 20 EAST",
            "address_2": "SUITE C",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-897-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAH THOMPSON GAGNON, D.M.D, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "GAGNON",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "THOMPSON",
        "authorized_official_title_or_position": "DOCTOR OF DENTAL MEDICINE",
        "authorized_official_telephone_number": "850-897-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 17297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1235273392",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.