John W. Leclair DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS017092L Issued in PA

Legal business name

JOHN W. LECLAIR DMD

Doing business as

Dental Health Care Center

Practice address

1315 W College Ave
Suite 201
State College, PA 16801-2776

Phone

(814) 954-7620

Fax

(814) 308-9985

NPI assigned

Jan 26, 2017

Organization subpart

No

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

Authorized official

Name

John W Leclair, D.M.D.NPI 1396874863

Title

Owner

Phone

(814) 441-4432

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dental Health Care Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John William Leclair, D.M.D.

  • General Practice Dentistry
  • State College, PA
  • NPI 1396874863
  NPD (past) Authorized official

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1942747183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W COLLEGE AVE",
            "address_2": "SUITE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012776",
            "telephone_number": "814-954-7620",
            "fax_number": "814-308-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W COLLEGE AVE",
            "address_2": "SUITE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012776",
            "telephone_number": "814-954-7620",
            "fax_number": "814-308-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. LECLAIR DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "LECLAIR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-441-4432",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS017092L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010324310005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nicole Ardell Johndrow, LSW
• Amanda Johnson
• Jennifer Twichell Johnson, LCSW
• Kimberly Johnson
• Matthew Ethan Johnson, PA-C

• General Practice Dentistry in State College, PA
• Providers in State College, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.