Active NPI
Kyle Leach, DMD
- Dentist
- Fort Leonard Wood, MO
National Provider Identifier
1043701105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D010024
- Practice address
- 6958 Nebraska Ave
Fort Leonard Wood, MO 65473-1618 - Phone
- (573) 596-0408
- NPI assigned
- May 24, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D010024 | AZ | Primary |
Addresses
Primary practice location
6958 Nebraska Ave
Fort Leonard Wood, MO 65473-1618
Mailing address
US Army Dental Activity
6958 Nebraska Ave
Fort Leonard Wood, MO 65473
Phone (573) 596-0364
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D010024 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633478400000",
"number": "1043701105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "US ARMY DENTAL ACTIVITY",
"address_2": "6958 NEBRASKA AVE",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "65473",
"telephone_number": "573-596-0364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6958 NEBRASKA AVE",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654731618",
"telephone_number": "573-596-0408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEACH",
"first_name": "KYLE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-24",
"last_updated": "2021-10-06",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D010024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Leonard Wood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.