Individual provider Active NPI

Leslie Medina

  • Dental Hygienist
  • Kennett Square, PA
National Provider Identifier
1336817691
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH073746 Issued in PA
Practice address
401 Cedar Woods Cir
Kennett Square, PA 19348-4233
Phone
(610) 880-9258
NPI assigned
Sep 1, 2021
Last updated
Sep 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH073746 PA Primary

Addresses

Primary practice location

401 Cedar Woods Cir
Kennett Square, PA 19348-4233

Mailing address

401 Cedar Woods Cir
Kennett Square, PA 19348-4233

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
DH073746PAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1336817691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CEDAR WOODS CIR",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193484233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CEDAR WOODS CIR",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193484233",
            "telephone_number": "610-880-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "PA",
            "license": "DH073746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.