LESLIE DEHAVEN OD NPI 1114081106

NPI Information

  • NPI: 1114081106
  • Provider Name: LESLIE DEHAVEN, OD
  • Classification: Optometrist - 152W00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 122 HIGHWAY 76
    WHITE HOUSE, TN
    ZIP 37188
  • Phone: (615) 672-6896

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NPI Details

Leslie Dehaven, OD is an optometrist in White House, TN. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. Leslie Dehaven, OD NPI is 1114081106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

122 HIGHWAY 76
WHITE HOUSE, TN
ZIP 37188-291
Phone: (615) 672-6896
Fax: (615) 672-6783

The NPI 1114081106 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 12/21/2006 and was last updated on 5/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometrist1510DTKENTUCKYNo
2152W00000XOptometrist2276TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13944682MEDICARE ID-TYPE UNSPECIFIEDTENNESSEEOD PIN
23944682MEDICAIDTENNESSEE
3U86395MEDICARE UPINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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