Organization Active NPI

Dennis M. McLeod, M.D., Inc

  • Otolaryngology Physician
  • Petaluma, CA
National Provider Identifier
1801006804
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G22981 Issued in CA
Legal business name
DENNIS M. MCLEOD, M.D., INC
Practice address
106 Lynch Creek Way
Suite 9a
Petaluma, CA 94954-2356
Phone
(707) 762-3561
Fax
(707) 762-5174
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Dennis M McLeod, M.D.
Title
Owner
Phone
(707) 762-3561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X G22981 CA Primary

Addresses

Primary practice location

106 Lynch Creek Way
Suite 9a
Petaluma, CA 94954-2356

Mailing address

1310 Commerce St
Suite B
Petaluma, CA 94954-1469
Phone (707) 778-7862

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1801006804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 COMMERCE ST",
            "address_2": "SUITE B",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541469",
            "telephone_number": "707-778-7862",
            "fax_number": "707-778-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LYNCH CREEK WAY",
            "address_2": "SUITE 9A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542356",
            "telephone_number": "707-762-3561",
            "fax_number": "707-762-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS M. MCLEOD, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-762-3561",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G22981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.