Individual provider Active NPI

Paul J Leckowicz, DMD

  • Dentist
  • Newington, CT
National Provider Identifier
1457468704
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7852 Issued in CT
Practice address
103 Market Square
Newington, CT 06111
Phone
(860) 666-4678
Fax
(860) 666-7832
NPI assigned
Aug 24, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7852 CT Primary

Addresses

Primary practice location

103 Market Square
Newington, CT 06111

Mailing address

103 Market Square
Newington, CT 06111
Phone (860) 666-4678

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
7852CTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457468704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MARKET SQUARE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-666-4678",
            "fax_number": "860-666-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MARKET SQUARE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-666-4678",
            "fax_number": "860-666-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECKOWICZ",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "7852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

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.