Leanna Christine Shetler, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039199 Issued in PA

Practice address

11 Magnolia Cove Drive
Simpsonville, SC 29680-2968

Phone

(864) 610-4485

NPI assigned

Jul 2, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Leanna Christine Assid Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Tribe Dental LLC

  • Pediatric Dentistry
  • Simpsonville, SC
  • NPI 1235776568
  NPD Authorized official

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1811251036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MAGNOLIA COVE DRIVE",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296808905",
            "telephone_number": "864-610-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MAGNOLIA COVE DRIVE",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296802968",
            "telephone_number": "864-610-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETLER",
        "first_name": "LEANNA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "8184",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANNA",
            "last_name": "ASSID",
            "middle_name": "CHRISTINE",
            "prefix": "DR.",
            "credential": "D.M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Courtney Shaw
• Michael Shea
• Allen Hugh Sheffield
• Ihab Mouris Botros Shenouda, M.D.
• Kathleen Jo Sheppard, RN, FNPC
• Kelli K Shields
• Adam Patrick Shindle
• James Loran Shrouder III, MD
• Adam John Shumaker, PHARMD., RPH
• Blake William Siersema, PT, DPT

• General Practice Dentistry in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.