Leeanne Marie Klum, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6000-015 Issued in WI

Practice address

1225 Favor Dr
Viroqua, WI 54665-1170

Phone

(608) 637-2655

Fax

(608) 637-2298

NPI assigned

Jan 3, 2007

Last updated

Jan 24, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1912064189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 FAVOR DR",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546651170",
            "telephone_number": "608-637-2655",
            "fax_number": "608-637-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 FAVOR DR",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546651170",
            "telephone_number": "608-637-2655",
            "fax_number": "608-637-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUM",
        "first_name": "LEEANNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6000-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick K Kelley, CSAC,ICS
• Anna Killips, RD
• Briana Ann King, COTA
• Jennifer J Klar
• Jessica L Klein, PA-C
• Katherine Koenig
• Colin J. Kratochwill, PA
• Karlee Lyn Kreuzer
• Thomas Krieger-Fritsch, D.C.
• Lydiawati Kurniawan, PTA

• General Practice Dentistry in Viroqua, WI
• Providers in Viroqua, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.