Leonard Ray Fuqua Jr., DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS0000002917 Issued in TN

Practice address

505 N Kentucky St
Kingston, TN 37763-2630

Phone

(865) 376-4445

Fax

(865) 376-4441

NPI assigned

Nov 10, 2005

Last updated

Jul 5, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1063493500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N KENTUCKY ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632630",
            "telephone_number": "865-376-4445",
            "fax_number": "865-376-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N KENTUCKY ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632630",
            "telephone_number": "865-376-4445",
            "fax_number": "865-376-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "LEONARD",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS0000002917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian J. Fillmore, D.C.
• Rebecca Michelle Fitzgerald, APRN, NP-C
• Miranda Beck Fleming, M.S. CCC-SLP
• Kathy D. Fowler, L.C.S.W.
• Wayne King Fritts, DDS
• Kenneth P Fus, RPH
• Kimberly Garrison, PT
• Beverly Kay Glasure, PA
• Kimberly Alice Goldborough, OTR
• Catherine Granbery, M.S. CCC-SLP

• Orthodontics and Dentofacial Orthopedics Dentistry in Kingston, TN
• Providers in Kingston, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.