Heeter, Kimberly Leeds

Heeter, Kimberly Leeds is an individual health care provider with primary practice located at 1113 Progress Dr , Medford OR 97504-5201. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Heeter, Kimberly Leeds can be contacted via phone (541) 512-3900.

Contact Information

Primary practice address
1113 Progress Dr Medford OR 97504-5201
Phone: (541) 512-3900
Fax: (541) 414-1175
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 21299 Texas
Dental Providers / Pediatric Dentistry 1223P0221X DE60088337 Washington
Dental Providers / Pediatric Dentistry 1223P0221X D10197 Oregon

Profile Details

NPI number 1811965593
LBN Legal business name Heeter, Kimberly Leeds
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Feb 25th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811965593 NPPES
Texas MEDICAID 1742900-01

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