Active NPI
McLeod Periodontics
- Periodontics
- Hazelwood, MO
National Provider Identifier
1154576890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 015787
- Legal business name
- MCLEOD PERIODONTICS
- Practice address
- 5992 Howdershell Rd
Suite 204
Hazelwood, MO 63042-4107 - Phone
- (314) 731-1700
- Fax
- (314) 731-1784
- NPI assigned
- Nov 21, 2008
- Organization subpart
- Yes
- Parent organization
- MCLEOD PERIODONTICS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dwight E. McLeod, DDS
- Title
- Owner
- Phone
- (314) 731-1700
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 015787 | MO | Primary |
Addresses
Primary practice location
5992 Howdershell Rd
Suite 204
Hazelwood, MO 63042-4107
Mailing address
5992 Howdershell Rd.
Suite 204
Hazelwood, MISSOURI 63042
UM
National Provider Directory
National Provider Directory- Part of
- McLeod Periodontics
Locations
5992 Howdershell Rd
Ste 204
Hazelwood, MO 63042
Phone (314) 731-1700
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Periodontics
- Mexico, MO
- NPI 1063610392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227225600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1227225600000",
"number": "1154576890",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "5992 HOWDERSHELL RD.",
"address_2": "SUITE 204",
"city": "HAZELWOOD",
"state": "MISSOURI",
"postal_code": "63042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5992 HOWDERSHELL RD",
"address_2": "SUITE 204",
"city": "HAZELWOOD",
"state": "MO",
"postal_code": "630424107",
"telephone_number": "314-731-1700",
"fax_number": "314-731-1784"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCLEOD PERIODONTICS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MCLEOD PERIODONTICS",
"enumeration_date": "2008-11-21",
"last_updated": "2008-11-21",
"status": "A",
"authorized_official_last_name": "MCLEOD",
"authorized_official_first_name": "DWIGHT",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "314-731-1700",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": "MO",
"license": "015787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazelwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.