Individual provider Active NPI

Samuel Martin Leggitt, DDS

  • Public Health Dentistry
  • Sarasota, FL
National Provider Identifier
1487062857
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DN22744 Issued in FL
Practice address
5425 Fruitville Rd Ste 16
Sarasota, FL 34232-6418
Phone
(941) 343-9777
NPI assigned
Jul 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6127C1 AL
Public Health Dentistry 1223D0001X DN22744 FL Primary

Addresses

Primary practice location

5425 Fruitville Rd Ste 16
Sarasota, FL 34232-6418

Mailing address

5425 Fruitville Rd Ste 16
Sarasota, FL 34232-6418
Phone (989) 284-7042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170920001800 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103190772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6127C1ALMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487062857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 FRUITVILLE RD STE 16",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326418",
            "telephone_number": "989-284-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 FRUITVILLE RD STE 16",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326418",
            "telephone_number": "941-343-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGITT",
        "first_name": "SAMUEL",
        "middle_name": "MARTIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6127C1",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN22744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.