Active NPI
Leslie Medina
- Dental Hygienist
- Kennett Square, PA
National Provider Identifier
1336817691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH073746
- Practice address
- 401 Cedar Woods Cir
Kennett Square, PA 19348-4233 - Phone
- (610) 880-9258
- NPI assigned
- Sep 1, 2021
- Last updated
- Sep 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DH073746 | PA | MD | Dental 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.