Individual provider Active NPI

Leighton Margaret Kennedy, D.M.D.

  • Dentist
  • Concord, NC
National Provider Identifier
1316208077
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9302 Issued in NC
Practice address
1020 Lee Ann Dr NE
Concord, NC 28025-2911
Phone
(704) 795-1055
Fax
(704) 795-6743
NPI assigned
May 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9302 NC Primary

Addresses

Primary practice location

1020 Lee Ann Dr NE
Concord, NC 28025-2911

Mailing address

1020 Lee Ann Dr NE
Concord, NC 28025-2911
Phone (704) 795-1055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160407001613 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6800194846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9302NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Leighton M. Kennedy, DMD, PLLC Current Accepting new patients

Organizations & group practices 1

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1316208077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-795-1055",
            "fax_number": "704-795-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-795-1055",
            "fax_number": "704-795-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LEIGHTON",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.