Legacy Dental Group PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEGACY DENTAL GROUP PLLC

Practice address

9951 Mickelberry Rd NW
Suite #215
Silverdale, WA 98383-8309

Phone

(360) 692-9701

NPI assigned

Sep 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Brian V Kerr, DMD

Title

Owner

Phone

(253) 584-6200

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1922359744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9951 MICKELBERRY RD NW",
            "address_2": "SUITE #215",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838309",
            "telephone_number": "360-692-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 MICKELBERRY RD NW",
            "address_2": "SUITE #215",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838309",
            "telephone_number": "360-692-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "KERR",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-584-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Motuz Leen, MD
• Victor Leen, MD
• Shayla E. Leer, P.T.
• Corbin Eugene Lefebvre
• Stephanie Leftwich-Needham
• Brian Wade Legendre, M.D., M.P.H.
• Alex Toldi Legocki, MD
• Stephen J Lemon, MD
• Paul E Lewis, M.D.
• Tyree Lewis

• General Practice Dentistry in Silverdale, WA
• Providers in Silverdale, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.