NPIMap

Organization Active NPI

K and L Dental

  • General Practice Dentistry
  • Marion, IN
National Provider Identifier
1528139151
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009572 Issued in IN
Legal business name
K AND L DENTAL
Practice address
117 W Mulberry St
Marion, IN 46952-2667
Phone
(765) 664-0028
Fax
(765) 668-3658
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Dr. Chad R LeightyNPI 1851480461
Title
Owner
Phone
(765) 664-0028

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12009572 IN Primary

Addresses

Primary practice location

117 W Mulberry St
Marion, IN 46952-2667

Mailing address

117 W Mulberry St
Marion, IN 46952-2667
Phone (765) 664-0028

National Provider Directory

National Provider Directory

Locations

117 W Mulberry St
Marion, IN 46952
Phone (765) 664-0028

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1528139151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W MULBERRY ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522667",
            "telephone_number": "765-664-0028",
            "fax_number": "765-668-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W MULBERRY ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522667",
            "telephone_number": "765-664-0028",
            "fax_number": "765-668-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K AND L DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "LEIGHTY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-664-0028",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.