Individual provider Active NPI

Leslie Anne Ehlen, D.D.S.

  • General Practice Dentistry
  • Clive, IA
National Provider Identifier
1639377369
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08896 Issued in IA
Practice address
11088 Hickman Rd
Clive, IA 50325-3740
Phone
(515) 278-2253
Fax
(515) 278-2392
NPI assigned
Jul 3, 2007
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08896 IA Primary

Addresses

Primary practice location

11088 Hickman Rd
Clive, IA 50325-3740

Mailing address

11088 Hickman Rd
Clive, IA 50325-3740
Phone (515) 278-2253

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

State licenses

LicenseStateTypeSpecialty
08896IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Creek Dental LLC PastSince Jun 16, 2024 Accepting new patients
Steffany L Mohan DDS PC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1639377369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11088 HICKMAN RD",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503253740",
            "telephone_number": "515-278-2253",
            "fax_number": "515-278-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11088 HICKMAN RD",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503253740",
            "telephone_number": "515-278-2253",
            "fax_number": "515-278-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLEN",
        "first_name": "LESLIE",
        "middle_name": "ANNE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.