Leo J. Durrett Jr., D.D.S., P.A.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN6009 Issued in FL

Practice address

8600 15TH Lane, North
St. Petersburg, FL 33702

Phone

(727) 576-0037

Fax

(727) 576-0037

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1225175268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 15TH LANE, NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-576-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 15TH LANE, NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-576-0037",
            "fax_number": "727-576-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURRETT",
        "first_name": "LEO",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simone Danielle Durant, HAIR LOSS SPECIALIST
• Andrew James Duren, MD
• Melinda Lane Duren, ARNP
• Joseph Mathew Durgin, LCSW
• Stephanie Durocher, DC
• Julia Durso, PMHNP
• Madison Marie Duschek
• Dutta LLC
• Amanda Duvall, MD
• Danielle Alexandra Duvoisin, NP

• Orthodontics and Dentofacial Orthopedics Dentistry in St. Petersburg, FL
• Providers in St. Petersburg, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.