Individual provider Active NPI

Leonard Tatro Jr., D.D.S.

  • Dentist
  • Big Stone Gap, VA
National Provider Identifier
1376761502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401410170 Issued in VA
Practice address
272 Dogwood Drive
Big Stone Gap, VA 24219
Phone
(276) 523-3310
NPI assigned
Apr 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401410170 VA Primary
Dentist 122300000X DS0000007588 TN

Addresses

Primary practice location

272 Dogwood Drive
Big Stone Gap, VA 24219

Mailing address

3744 Arrowhead TRL
Kingsport, TN 37664-2102

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
DS0000007588TNMDDentist
0401410170VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376761502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3744 ARROWHEAD TRL",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 DOGWOOD DRIVE",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "24219",
            "telephone_number": "276-523-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATRO",
        "first_name": "LEONARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410170",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS0000007588",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Stone Gap, VA

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.

Verify at the official NPI Registry.