Active NPI
Leonard S Tibbetts, D.D.S, M.S.D.
- Periodontics
- Arlington, TX
National Provider Identifier
1366502494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 8336
- Practice address
- 916 W Mitchell St
Arlington, TX 76013-2537 - Phone
- (817) 265-1341
- Fax
- (817) 274-0872
- NPI assigned
- Dec 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 8336 | TX | Primary |
Addresses
Primary practice location
916 W Mitchell St
Arlington, TX 76013-2537
Mailing address
916 W Mitchell St
Arlington, TX 76013-2537
Phone (817) 265-1341
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8336 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366502494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 W MITCHELL ST",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760132537",
"telephone_number": "817-265-1341",
"fax_number": "817-274-0872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 W MITCHELL ST",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760132537",
"telephone_number": "817-265-1341",
"fax_number": "817-274-0872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBBETTS",
"first_name": "LEONARD",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.D.S, M.S.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "8336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.