Michael Kinon Lecholop, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4462 Issued in SC

Practice address

173 Ashley Ave
Charleston, SC 29425-8908

Phone

(843) 792-1414

NPI assigned

Jul 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Charleston Oral and Facial Surgery, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Ladson, SC
  • NPI 1043409063
  NPD (past)
• Charleston Oral Medicine, LLC

  • Dental Clinic/Center
  • Ladson, SC
  • NPI 1346925781
  NPD (past)
• Coafs Lab

  • Oral and Maxillofacial Surgery (Dentist)
  • Charleston, SC
  • NPI 1679954705
  NPD (past)

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1902069271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECHOLOP",
        "first_name": "MICHAEL",
        "middle_name": "KINON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4462",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "4462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Nan Leath, MD, MSCR
• Mary Pasquini Leathers, DDS
• Barbara Ann Lebarron, R.PH.
• Dustin Paul Leblanc, M.D.
• Faye Leboeuf, CNM
• Anne Hawk Leclercq, M.D.
• Meredith Sams Ledbetter, APRN
• Lee R Leddy, MD
• Rebecca Joann Leddy, M.D.
• Jill Lederman

• Oral and Maxillofacial Surgery (Dentist) in Charleston, SC
• Providers in Charleston, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.