Individual provider Active NPI

Leslie Erin Siegfried, DDS

  • General Practice Dentistry
  • Murfreesboro, TN
National Provider Identifier
1134416407
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3838 Issued in AR
Practice address
2626 Merchants Walk
Murfreesboro, TN 37128-2863
Phone
(615) 225-8903
Fax
(615) 225-8915
NPI assigned
Jul 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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 3838 AR Primary

Addresses

Primary practice location

2626 Merchants Walk
Murfreesboro, TN 37128-2863

Mailing address

12 Marlou Drive
Cabot, AR 72023
Phone (501) 628-5555

Other identifiers 1

IdentifierTypeStateIssuer
197469608MedicaidAR

Other names 1

  • Leslie Erin Ringgold Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20231228001564 AR Order and Referring Only - DentistPractitioner - Dentist 1557672953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3838ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Marquis Mobile Dental Services LLC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1134416407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MARLOU DRIVE",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "72023",
            "telephone_number": "501-628-5555",
            "fax_number": "501-628-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 MERCHANTS WALK",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371282863",
            "telephone_number": "615-225-8903",
            "fax_number": "615-225-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGFRIED",
        "first_name": "LESLIE",
        "middle_name": "ERIN",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197469608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "RINGGOLD",
            "middle_name": "ERIN",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.