# DR. KIMBERLY LEEDS HEETER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1811965593
- **Gender:** F
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 21299 | TX | — |
| 1223P0221X | Pediatric Dentistry | D10197 | OR | Yes |
| 1223P0221X | Pediatric Dentistry | DE60088337 | WA | — |

## Other

- **Enumeration date:** 03/09/2006
- **Last updated:** 02/25/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1742900-01 | — | TX |