Katherine Lynn Leiva, RDH
Individual provider Active NPI Dental Hygienist · Pingree Grove, IL
NPI 1124666573 · NPPES record last updated Dec 17, 2019
Key facts
- NPI
- 1124666573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 020012552 (IL)
- Practice address
- 1791 Dempsey Cir
Pingree Grove, IL 60140-8019 - Phone
- (815) 325-1114
- NPI assigned
- Dec 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 020012552 | IL | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 020012552 | IL | Yes |
Addresses
Primary practice location
1791 Dempsey Cir
Pingree Grove, IL 60140-8019
Mailing address
1791 Dempsey Cir
Pingree Grove, IL 60140-8019
Phone (815) 325-1114
Other names
- Mrs. Katherine Lynn Leiva
Other providers in Pingree Grove, IL
- Jump for Joy Therapy Services Inc
- Kish Optical Inc.
- Mary Sue Kruchten
- Gina Lawrence
- Angela Christine Leeser
- Isabella Malek
- Medride LLC
- Rebecca Ann Mensching
- Dianne Joy Mindac
- Northwest Dentiq Center P.C.
All providers in Pingree Grove, IL · Dental Hygienist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2019. 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.