Individual provider Active NPI

Lowen A Leatherman

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1427124700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
K55203 Issued in KS
Practice address
8015 E Peach Tree LN
Wichita, KS 67207-1139
Phone
(316) 685-5121
Fax
(316) 685-8050
NPI assigned
Nov 28, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X K55203 KS Primary

Addresses

Primary practice location

8015 E Peach Tree LN
Wichita, KS 67207-1139

Mailing address

8015 E Peach Tree LN
Wichita, KS 67207-1139
Phone (316) 685-5121

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
K55203KSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427124700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 E PEACH TREE LN",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672071139",
            "telephone_number": "316-685-5121",
            "fax_number": "316-685-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 E PEACH TREE LN",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672071139",
            "telephone_number": "316-685-5121",
            "fax_number": "316-685-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERMAN",
        "first_name": "LOWEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "K55203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

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.