NPIMap

Organization Active NPI

Leslie Wells DMD, PLLC

Doing business as New Augusta Dental

  • General Practice Dentistry
  • New Augusta, MS
National Provider Identifier
1225369705
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
343207 Issued in MS
Legal business name
LESLIE WELLS DMD, PLLC
Doing business as
New Augusta Dental
Practice address
203 Pine Street West
New Augusta, MS 39462-0411
Phone
(601) 964-8400
Fax
(601) 964-8400
NPI assigned
Jan 22, 2010
Last updated
Jan 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Authorized official

Name
Dr. Leslie Rae Wells, DMDNPI 1053598433
Title
Owner
Phone
(601) 964-8400

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)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 343207 MS Primary

Addresses

Primary practice location

203 Pine Street West
New Augusta, MS 39462-0411

Mailing address

PO Box 411
New Augusta, MS 39462-0411
Phone (601) 964-8400

Other identifiers 1

IdentifierTypeStateIssuer
05838340MedicaidMS

Other names 1

  • New Augusta Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1225369705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411",
            "city": "NEW AUGUSTA",
            "state": "MS",
            "postal_code": "394620411",
            "telephone_number": "601-964-8400",
            "fax_number": "601-964-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 PINE STREET WEST",
            "city": "NEW AUGUSTA",
            "state": "MS",
            "postal_code": "394620411",
            "telephone_number": "601-964-8400",
            "fax_number": "601-964-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE WELLS DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-964-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "343207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05838340",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Augusta Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Augusta, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.