Robert McLeod

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

48747 Issued in CA

Practice address

2675 Irvine Ave
Suite C
Costa Mesa, CA 92627-4653

Phone

(949) 548-8287

Fax

(949) 548-8076

NPI assigned

Nov 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1083695100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 IRVINE AVE",
            "address_2": "SUITE C",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926274653",
            "telephone_number": "949-548-8287",
            "fax_number": "949-548-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 IRVINE AVE",
            "address_2": "SUITE C",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926274653",
            "telephone_number": "949-548-8287",
            "fax_number": "949-548-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "48747",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OK",
            "license": "56",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kenneth McKindley, D.P.T.
• Symone McKinnon
• Cynthia McKnight
• Evan Royce McLain, PHARMD
• Ashley McLaughlin, LMFT
• Reed McMillan
• Brian McNamara
• David L McNeil, ATC
• Susanna McPeak, NP
• Charles Anthony McPhail Sr., PHD, LCSW

• Periodontics in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.