Individual provider Active NPI

Mackenzie Sewell Lecroy, DDS

  • General Practice Dentistry
  • Hickory, NC
National Provider Identifier
1083230866
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11876 Issued in NC
Practice address
221 13TH Avenue PL NW
Hickory, NC 28601-2549
Phone
(828) 328-5581
NPI assigned
Jun 17, 2020
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11876 NC Primary

Addresses

Primary practice location

221 13TH Avenue PL NW
Hickory, NC 28601-2549

Mailing address

221 13TH Avenue PL NW
Hickory, NC 28601-2549
Phone (828) 328-5581

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

LicenseStateTypeSpecialty
11876NCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1083230866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 13TH AVENUE PL NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012549",
            "telephone_number": "828-328-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 13TH AVENUE PL NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012549",
            "telephone_number": "828-328-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECROY",
        "first_name": "MACKENZIE",
        "middle_name": "SEWELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.