Active NPI
Letitia Randall, DDS
- Dentist
- Kalamazoo, MI
National Provider Identifier
1760476444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901020148
- Practice address
- 401 S Drake Rd
Kalamazoo, MI 49009-1216 - Phone
- (269) 344-1271
- NPI assigned
- Sep 8, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901020148 | MI | Primary |
Addresses
Primary practice location
401 S Drake Rd
Kalamazoo, MI 49009-1216
Mailing address
401 S Drake Rd
Kalamazoo, MI 49009-1216
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020148 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272585600000",
"number": "1760476444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S DRAKE RD",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490091216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S DRAKE RD",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490091216",
"telephone_number": "269-344-1271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "LETITIA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-08",
"last_updated": "2010-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901020148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.