Marden Kahle Leavitt, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5956245 Issued in UT

Practice address

111 E 100 S
St George, UT 84770-3428

Phone

(435) 673-6831

Fax

(435) 673-6840

NPI assigned

Sep 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1578712337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 100 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703428",
            "telephone_number": "435-673-6831",
            "fax_number": "435-673-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 100 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703428",
            "telephone_number": "435-673-6831",
            "fax_number": "435-673-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "MARDEN",
        "middle_name": "KAHLE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5956245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Bishop Leavitt, D.O.
• Cort Berne Leavitt, MD
• Emme Leavitt
• Kassidy Leavitt
• Lydia Kristin Leavitt
• Mickell Leavitt
• Sara Leavitt
• Tessa Rose Leavitt
• Lesley Lechuga
• Makenzie Noel Leduc

• General Practice Dentistry in St George, UT
• Providers in St George, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.