NPIMap

Organization Active NPI

Brian K. Leach, D.D.S.

  • General Practice Dentistry
  • Shell Knob, MO
National Provider Identifier
1235459447
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2009011494 Issued in MO
Legal business name
BRIAN K. LEACH, D.D.S.
Practice address
25376 State Highway 39
Suite 201
Shell Knob, MO 65747-7343
Phone
(417) 858-6527
Fax
(417) 858-2570
NPI assigned
Jun 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Authorized official

Name
Dr. Brian K. Leach, D.D.S.NPI 1104038074
Title
Dentist/Practice Owner
Phone
(417) 858-6527

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2009011494 MO Primary

Addresses

Primary practice location

25376 State Highway 39
Suite 201
Shell Knob, MO 65747-7343

Mailing address

25376 State Highway 39
Suite 201
Shell Knob, MO 65747-7343
Phone (417) 858-6527

Other names 1

  • Shell Knob Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

25376 State Highway 39
Ste 201
Shell Knob, MO 65747
Phone (417) 858-6527

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1235459447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25376 STATE HIGHWAY 39",
            "address_2": "SUITE 201",
            "city": "SHELL KNOB",
            "state": "MO",
            "postal_code": "657477343",
            "telephone_number": "417-858-6527",
            "fax_number": "417-858-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25376 STATE HIGHWAY 39",
            "address_2": "SUITE 201",
            "city": "SHELL KNOB",
            "state": "MO",
            "postal_code": "657477343",
            "telephone_number": "417-858-6527",
            "fax_number": "417-858-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN K. LEACH, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DENTIST/PRACTICE OWNER",
        "authorized_official_telephone_number": "417-858-6527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2009011494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shell Knob Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shell Knob, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.