Provider Demographics
NPI:1417517178
Name:KALDENBERG-LEPPERT, JESSEKA (DPM)
Entity Type:Individual
Prefix:
First Name:JESSEKA
Middle Name:
Last Name:KALDENBERG-LEPPERT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 N ANKENY BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4619
Mailing Address - Country:US
Mailing Address - Phone:515-639-3775
Mailing Address - Fax:
Practice Address - Street 1:3720 N ANKENY BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4619
Practice Address - Country:US
Practice Address - Phone:515-639-3775
Practice Address - Fax:515-964-3012
Is Sole Proprietor?:No
Enumeration Date:2019-06-15
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA097017213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA097017OtherIOWA STATE LICENSE