Paul Michael McLeod, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1223G0001X Issued in IN

Practice address

919 E Jefferson Blvd Ste LL02
South Bend, IN 46617-3119

Phone

(574) 233-7331

Fax

(574) 233-3434

NPI assigned

Feb 20, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Paul Michael McLeod DDS, Inc.

  • General Practice Dentistry
  • South Bend, IN
  • NPI 1790909000
  NPD (past) Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1962670208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 E JEFFERSON BLVD STE LL02",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173119",
            "telephone_number": "574-233-7331",
            "fax_number": "574-233-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 E JEFFERSON BLVD STE LL02",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173119",
            "telephone_number": "574-233-7331",
            "fax_number": "574-233-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009809A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "1223G0001X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200091260A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chyna McKnight
• Lela McKnight
• Rebecca Rochelle McKown, MD
• Scott McLaughlin, PA-C, M.S.
• Jasmine McLeod
• Amy H McMahon, O.T.
• Sarah McMahon, FNP-BC
• Abigail McManus, RBT
• Justin McMenamy, PHARMD
• Whitney McMillin, BSW

• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.