Leticia Fernandez-Ranson
Individual provider Active NPI General Practice Dentistry · Morton, IL
NPI 1659407153 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1659407153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 320 E Jackson St
Morton, IL 61550-1628 - Phone
- (309) 263-2021
- Fax
- (309) 266-6895
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019021949 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
320 E Jackson St
Morton, IL 61550-1628
Mailing address
15 Diamond PT
Morton, IL 61550-1186
Other providers in Morton, IL
- Elysian Hospice, Inc
- Amber Brittany Emmons
- Darlene G Esken
- Sue A Feather
- Femmecare Health & Wellness
- Ronald James Flanigan
- Steven R. Floyd
- Focus on Eyes, P.C.
- Kimberly Yvette Ford
- Chloe Fouts
All providers in Morton, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.