Individual provider Active NPI

Leonard L Weldon, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Keene, NH
National Provider Identifier
1174569099
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3047 Issued in NH
Practice address
272 Main St
Keene, NH 03431-4144
Phone
(603) 357-3709
Fax
(603) 352-5722
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3047 NH Primary

Addresses

Primary practice location

272 Main St
Keene, NH 03431-4144

Mailing address

250 Pleasant St
Concord, NH 03301-2598
Phone (603) 227-7035

Other practice location 1

250 Pleasant St
Concord, NH 03301-2598
Phone (603) 227-7035

Other identifiers 2

IdentifierTypeStateIssuer
1006186MedicaidVT
30011490MedicaidNH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lweldon@crhc.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060511000067 NH Practitioner - Maxillofacial Surgery 8426069055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Hospital, Inc. Current Accepting new patients

Locations

246 Pleasant St
Concord, NH 03301
Phone (603) 224-1223

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

Organizations & group practices 2

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1174569099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012598",
            "telephone_number": "603-227-7035",
            "fax_number": "603-227-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 MAIN ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034314144",
            "telephone_number": "603-357-3709",
            "fax_number": "603-352-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Pleasant St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033012598",
            "country_code": "US",
            "telephone_number": "603-227-7035",
            "fax_number": "603-227-7562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELDON",
        "first_name": "LEONARD",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NH",
            "license": "3047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006186",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30011490",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lweldon@crhc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Concord Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "250 Pleasant St",
            "city": "Concord",
            "state": "NH",
            "country_code": "US",
            "postal_code": "033012598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.