Individual provider Active NPI

Leslie M Pitts, D.M.D.

  • Pediatric Dentistry
  • Commerce, GA
National Provider Identifier
1881770717
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN013095 Issued in GA
Practice address
215 Mercer PL
Commerce, GA 30529-1564
Phone
(706) 335-7793
Fax
(706) 335-7815
NPI assigned
Oct 31, 2006
Last updated
Jul 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN013095 GA Primary

Addresses

Primary practice location

215 Mercer PL
Commerce, GA 30529-1564

Mailing address

215 Mercer PL
PO Box 1241
Commerce, GA 30529-1564
Phone (706) 335-7793

Other identifiers 1

IdentifierTypeStateIssuer
9184440OtherGADORAL

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

LicenseStateTypeSpecialty
DN013095GAMDPediatric Dentist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1881770717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MERCER PL",
            "address_2": "PO BOX 1241",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291564",
            "telephone_number": "706-335-7793",
            "fax_number": "706-335-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MERCER PL",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291564",
            "telephone_number": "706-335-7793",
            "fax_number": "706-335-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTS",
        "first_name": "LESLIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9184440",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.