Provider Demographics
NPI:1710501705
Name:LEACH, KAYLA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:LEACH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7932 NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3965
Mailing Address - Country:US
Mailing Address - Phone:316-218-2722
Mailing Address - Fax:
Practice Address - Street 1:15010 S BLACKBOB RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2663
Practice Address - Country:US
Practice Address - Phone:913-764-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61958122300000X
MO2021022288122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist