Leslie Denise Holmes-Leach, DMD
Individual provider Active NPI Dentist · Rocky Top, TN
NPI 1104100064 · NPPES record last updated Jun 18, 2020
Key facts
- NPI
- 1104100064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS0000009427 (TN)
- Practice address
- 305 S Main St
Rocky Top, TN 37769-2206 - Phone
- (865) 426-7421
- Fax
- (865) 426-7422
- NPI assigned
- Oct 10, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0000009427 | TN | MD | Dentist |
| 9427 | TN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark D Evans DDS | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7055 | SC | |
| General Practice Dentistry | 1223G0001X | 9427 | TN | |
| Dentist | 122300000X | DS0000009427 | TN | Yes |
Addresses
Primary practice location
305 S Main St
Rocky Top, TN 37769-2206
Mailing address
PO Box 599
Rocky Top, TN 37769-0599
Phone (865) 426-7421
Other providers in Rocky Top, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.