Active NPI
Leo Raymond Cullinan, D.D.S., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Naples, FL
National Provider Identifier
1619106937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN11051
- Practice address
- 4933 Tamiami TRL N
Suite 101
Naples, FL 34103-3028 - Phone
- (239) 434-0030
- NPI assigned
- Jul 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN11051 | FL | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 14382 | MO |
Addresses
Primary practice location
4933 Tamiami TRL N
Suite 101
Naples, FL 34103-3028
Mailing address
4933 Tamiami TRL N
Suite 101
Naples, FL 34103-3028
Phone (239) 434-0030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN11051 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 14382 | MO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1619106937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4933 TAMIAMI TRL N",
"address_2": "SUITE 101",
"city": "NAPLES",
"state": "FL",
"postal_code": "341033028",
"telephone_number": "239-434-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4933 TAMIAMI TRL N",
"address_2": "SUITE 101",
"city": "NAPLES",
"state": "FL",
"postal_code": "341033028",
"telephone_number": "239-434-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLINAN",
"first_name": "LEO",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-08",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DN11051",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MO",
"license": "14382",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.