Individual provider Active NPI

Leigh Ann Patel, DMD, MS

  • Pediatric Dentistry
  • Canton, GA
National Provider Identifier
1134448301
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN014076 Issued in GA
Practice address
12420 Cumming Hwy
Ste 306
Canton, GA 30115-7568
Phone
(678) 947-3600
NPI assigned
May 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN014076 GA Primary

Addresses

Primary practice location

12420 Cumming Hwy
Ste 306
Canton, GA 30115-7568

Mailing address

12420 Cumming Hwy
Ste 306
Canton, GA 30115-7568
Phone (678) 947-3600

Other identifiers 1

IdentifierTypeStateIssuer
465659589BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN014076GAMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: ltrotter43178@choa.gadirect.net

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1134448301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12420 CUMMING HWY",
            "address_2": "STE 306",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157568",
            "telephone_number": "678-947-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12420 CUMMING HWY",
            "address_2": "STE 306",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157568",
            "telephone_number": "678-947-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "LEIGH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465659589B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.