NPIMap

Organization Active NPI

Dr. Carl a-M Leonard, DDS, PC

  • Dental Clinic/Center
  • Skokie, IL
National Provider Identifier
1104467281
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DR. CARL A-M LEONARD, DDS, PC
Doing business as
Dental Reconstruction Center
Practice address
4711 Golf Rd Ste 711
Skokie, IL 60076-1245
Phone
(847) 673-2455
Fax
(847) 673-3616
NPI assigned
Sep 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Authorized official

Name
Dr. Carl A-M Leonard, DDS
Title
Owner
Phone
(847) 673-2455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4711 Golf Rd Ste 711
Skokie, IL 60076-1245

Mailing address

4711 Golf Rd Ste 711
Skokie, IL 60076-1245
Phone (847) 673-2455

Other names 1

  • Dental Reconstruction Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1104467281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 711",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761245",
            "telephone_number": "847-673-2455",
            "fax_number": "847-673-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 711",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761245",
            "telephone_number": "847-673-2455",
            "fax_number": "847-673-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CARL A-M LEONARD, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "A-M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-673-2455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Reconstruction Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.