Ethan Patrick McLeod

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

063502 Issued in NY

Practice address

827 11TH Ave
New York, NY 10019-3535

Phone

(212) 369-5566

NPI assigned

Mar 20, 2022

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Century Medical & Dental Center Inc

  • Health Service Clinic/Center
  • Brooklyn, NY
  • NPI 1144399098
  NPD
• Niranjan K Mittal, Physician, PLLC

  • Cardiovascular Disease Physician
  • Brooklyn, NY
  • NPI 1811939465
  NPD (past)

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

{
    "created_epoch": "1647734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1942959754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 WILD BIRD LN",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320806113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 11TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193535",
            "telephone_number": "212-369-5566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5008 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202167",
            "country_code": "US",
            "telephone_number": "718-210-1030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "ETHAN",
        "middle_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-20",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucia McLendon, MD
• Negene McLennon
• Sharon Melisse McLennon, MSED., CRC, LMHC
• Alexander McLeod, NP
• Devon McLeod, LCSW
• Joni McLeod, LMHC
• Kimberly McLeod
• Lucy McLeod, B.PHYSIO, DPT, CHT
• Shakeima McLeod, LMSW
• Brian McLoughlin

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.