NPIMap

Organization Active NPI

Leavitt Family and Cosmetic Dentistry

  • General Practice Dentistry
  • Pocatello, ID
National Provider Identifier
1528227121
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEAVITT FAMILY AND COSMETIC DENTISTRY
Practice address
333 W Cedar St
Pocatello, ID 83201
Phone
(208) 233-6900
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Casey J. Leavitt, DDS PA
Title
Dr
Phone
(208) 233-6900

Specialties & licenses 1

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

Addresses

Primary practice location

333 W Cedar St
Pocatello, ID 83201

Mailing address

333 W Cedar St
Pocatello, ID 83201-5045
Phone (208) 233-6900

Other identifiers 1

IdentifierTypeStateIssuer
1531413OtherIDUNITED CONCORDIA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1528227121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W CEDAR ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015045",
            "telephone_number": "208-233-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W CEDAR ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-233-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAVITT FAMILY AND COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "208-233-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1531413",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.