Individual provider Active NPI

David Lawrence Leonard, D.D.S.

  • Dentist
  • Alexandria, MN
National Provider Identifier
1194975714
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9921 Issued in MN
Practice address
3015 Highway 29 S Ste 4176
Alexandria, MN 56308-4540
Phone
(320) 763-5052
Fax
(320) 763-5053
NPI assigned
Sep 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D9921 MN Primary

Addresses

Primary practice location

3015 Highway 29 S Ste 4176
Alexandria, MN 56308-4540

Mailing address

6600 France Ave S Ste 415
Edina, MN 55435-1817
Phone (952) 224-9771

Other identifiers 1

IdentifierTypeStateIssuer
207320000MedicaidMN

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

State licenses

LicenseStateTypeSpecialty
D9921MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1194975714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 415",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351817",
            "telephone_number": "952-224-9771",
            "fax_number": "952-224-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 29 S STE 4176",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084540",
            "telephone_number": "320-763-5052",
            "fax_number": "320-763-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "DAVID",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D9921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207320000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.

Verify at the official NPI Registry.