Individual provider Active NPI

Brent L Leggett, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brookhaven, MS
National Provider Identifier
1043317902
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
7949 Issued in MT
Practice address
601 Brookman Drive
Suite B
Brookhaven, MS 39601
Phone
(601) 833-4912
Fax
(601) 833-0045
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 8800 TN
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 00202670 CO
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 7949 MT Primary

Addresses

Primary practice location

601 Brookman Drive
Suite B
Brookhaven, MS 39601

Mailing address

2900 Central Ave
Orthodontic and Pediatric Clinic: Building #2
Billings, MT 59102-8626
Phone (406) 656-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
00202670COMDOrthodontics and Dentofacial Orthopedic Dentist
7949MTMDOrthodontics and Dentofacial Orthopedic Dentist
8800TNMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1043317902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CENTRAL AVE",
            "address_2": "ORTHODONTIC AND PEDIATRIC CLINIC: BUILDING #2",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591028626",
            "telephone_number": "406-656-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROOKMAN DRIVE",
            "address_2": "SUITE B",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "39601",
            "telephone_number": "601-833-4912",
            "fax_number": "601-833-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGETT",
        "first_name": "BRENT",
        "middle_name": "L",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "8800",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "00202670",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MT",
            "license": "7949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.