Organization Active NPI

Leighton M. Kennedy, DMD, PLLC

  • General Practice Dentistry
  • Mooresville, NC
National Provider Identifier
1497415491
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEIGHTON M. KENNEDY, DMD, PLLC
Practice address
134 Professional Park Dr Ste 100
Mooresville, NC 28117-5600
Phone
(704) 799-0377
NPI assigned
Dec 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Dr. Leighton M Kennedy, DMDNPI 1316208077
Title
Owner
Phone
(336) 601-6731

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

134 Professional Park Dr Ste 100
Mooresville, NC 28117-5600

Mailing address

19920 Scanmar LN
Cornelius, NC 28031-6305
Phone (336) 601-6731

National Provider Directory

National Provider Directory

Locations

134 Professional Park Dr
Ste 100
Mooresville, NC 28117
Phone (704) 799-0377

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1497415491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19920 SCANMAR LN",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316305",
            "telephone_number": "336-601-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 PROFESSIONAL PARK DR STE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175600",
            "telephone_number": "704-799-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEIGHTON M. KENNEDY, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-19",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "LEIGHTON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-601-6731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.