NPIMap

Organization Active NPI

Nathan D Leiske DDS PC

  • Dental Clinic/Center
  • Marion, IL
National Provider Identifier
1578071817
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019.030942 Issued in IL
Legal business name
NATHAN D LEISKE DDS PC
Practice address
1504 Sioux Dr
Marion, IL 62959-5209
Phone
(618) 997-0127
NPI assigned
Jan 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Nathan D Leiske, DDSNPI 1639457070
Title
Owner
Phone
(618) 997-0127

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
Dental Clinic/Center 261QD0000X 019.030942 IL Primary

Addresses

Primary practice location

1504 Sioux Dr
Marion, IL 62959-5209

Mailing address

1504 Sioux Dr
Marion, IL 62959-5209
Phone (618) 997-0127

National Provider Directory

National Provider Directory

Locations

1504 Sioux Dr
Marion, IL 62959
Phone (618) 997-0127

Practitioners & affiliated clinicians

Practitioners 5

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": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1578071817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 SIOUX DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595209",
            "telephone_number": "618-997-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 SIOUX DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595209",
            "telephone_number": "618-997-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN D LEISKE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "LEISKE",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-997-0127",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019.030942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.