Individual provider Active NPI

Timothy Werner Leonard, D.M.D.

  • General Practice Dentistry
  • Maysville, KY
National Provider Identifier
1821005133
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4718 Issued in KY
Practice address
123 West Second Street PO 217
Suite #B
Maysville, KY 41056
Phone
(606) 564-3375
Fax
(606) 564-3375
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4718 KY Primary

Addresses

Primary practice location

123 West Second Street PO 217
Suite #B
Maysville, KY 41056

Mailing address

123 West Second Street PO 217
Suite #B
Maysville, KY 41056
Phone (606) 564-3375

Other identifiers 1

IdentifierTypeStateIssuer
60047180MedicaidKY

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1821005133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WEST SECOND STREET PO 217",
            "address_2": "SUITE #B",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "41056",
            "telephone_number": "606-564-3375",
            "fax_number": "606-564-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WEST SECOND STREET PO 217",
            "address_2": "SUITE #B",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "41056",
            "telephone_number": "606-564-3375",
            "fax_number": "606-564-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "TIMOTHY",
        "middle_name": "WERNER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60047180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.