Maureen A Leclair-Dentler, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00028693 Issued in WA

Practice address

407 14TH Ave SE
Puyallup, WA 98372-3770

Phone

(253) 848-6661

Fax

(253) 770-5990

NPI assigned

Jun 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1679518112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8803 30TH STREET CT NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983356015",
            "telephone_number": "253-265-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723770",
            "telephone_number": "253-848-6661",
            "fax_number": "253-770-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECLAIR-DENTLER",
        "first_name": "MAUREEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00028693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8128068",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne Le
• Kelly Amanda Leaf, O.T.
• Angelina Stomlund Lease, BCBA-LBA
• Olivia Leavens-Saunders
• Ashley Elizabeth Leavitt
• David Leddy
• Lisa M Ledgerwood, D.C.
• Angela Lee
• Brian Lee, RPH
• Celeste Myong Suk Lee

• Emergency Medicine Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.