NPIMap

Organization Active NPI

Walter L. Leeks, III DMD, P.C.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1508076464
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 13122 Issued in GA
Legal business name
WALTER L. LEEKS, III DMD, P.C.
Practice address
245 N Highland Ave NE
Suite 260
Atlanta, GA 30307-1909
Phone
(404) 589-7799
Fax
(404) 214-9414
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Walter Louis Leeks III, DMD
Title
President
Phone
(404) 589-7799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN 13122 GA Primary

Addresses

Primary practice location

245 N Highland Ave NE
Suite 260
Atlanta, GA 30307-1909

Mailing address

245 N Highland Ave NE
Suite 260
Atlanta, GA 30307-1909
Phone (404) 589-7799

Other names 1

  • New Image Dentistry at Inman Park Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508076464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N HIGHLAND AVE NE",
            "address_2": "SUITE 260",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303071909",
            "telephone_number": "404-589-7799",
            "fax_number": "404-214-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N HIGHLAND AVE NE",
            "address_2": "SUITE 260",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303071909",
            "telephone_number": "404-589-7799",
            "fax_number": "404-214-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER L. LEEKS, III DMD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEEKS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-589-7799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN 13122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Image Dentistry at Inman Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.