Leanne Michelle Wallace, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

L751004 Issued in MI

Practice address

2215 Fuller Rd
Ann Arbor, MI 48105-2303

Phone

(734) 845-3411

NPI assigned

May 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Leanne Michelle Stapleton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1457518953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6723 HENRY RUFF RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481353401",
            "telephone_number": "734-522-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-845-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LEANNE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "L751004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANNE",
            "last_name": "STAPLETON",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Krysten Wall, LMSW
• Sarah Catherine Wall, MD
• James Allen Walla, RN
• Beth Ilene Wallace, MD
• Julia Wallace, MSW
• Michael Eugene Wallace, MA
• Nicholas Wallace, M.D.
• Stacia Wallace
• Sarah Mary Wallett, MD
• Kempland Walley

• Dental Hygienist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dental Hygienist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.