Individual provider Active NPI

Kelly Hud Leaird, D.M.D.

  • General Practice Dentistry
  • Lady Lake, FL
National Provider Identifier
1477576486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0014131 Issued in FL
Practice address
918 Rolling Acres Rd Ste 7
Lady Lake, FL 32159-5026
Phone
(352) 750-0300
Fax
(352) 750-1018
NPI assigned
Jul 25, 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 DN0014131 FL Primary

Addresses

Primary practice location

918 Rolling Acres Rd Ste 7
Lady Lake, FL 32159-5026

Mailing address

918 Rolling Acres Rd Ste 7
Lady Lake, FL 32159-5026
Phone (352) 750-0300

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
DN0014131FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477576486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 ROLLING ACRES RD STE 7",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595026",
            "telephone_number": "352-750-0300",
            "fax_number": "352-750-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 ROLLING ACRES RD STE 7",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595026",
            "telephone_number": "352-750-0300",
            "fax_number": "352-750-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAIRD",
        "first_name": "KELLY",
        "middle_name": "HUD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0014131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

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.