Leary Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8001 Issued in NC

Legal business name

LEARY FAMILY DENTISTRY

Practice address

10214 Couloak Drive
Charlotte, NC 28216

Phone

(704) 394-3109

Fax

(704) 394-3119

NPI assigned

May 14, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Carmen L. Leary, D.D.S.

Title

Owner

Phone

(704) 394-3109

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alessandra Marie Gutierrez, D.D.S.

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1588044200
  NPD (past)

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1063823862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10214 COULOAK DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28216",
            "telephone_number": "704-394-3109",
            "fax_number": "704-394-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10214 COULOAK DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28216",
            "telephone_number": "704-394-3109",
            "fax_number": "704-394-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEARY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "LEARY",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-394-3109",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Lear, PT, DPT
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• Allyssa Jayne Leary, BCBA
• Amy E Leary, L.C.S.W., L.C.A.S.
• Martha Leah Leary, LCSWA
• Matthew S. Burgess Leary, PH.D.
• Nicholas Leary, RN

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.