Healthcare Provider Details

I. General information

NPI: 1417517178
Provider Name (Legal Business Name): JESSEKA KALDENBERG-LEPPERT DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2019
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 N ANKENY BLVD STE 103
ANKENY IA
50023-4619
US

IV. Provider business mailing address

3720 N ANKENY BLVD STE 103
ANKENY IA
50023-4619
US

V. Phone/Fax

Practice location:
  • Phone: 515-639-3775
  • Fax: 515-964-3012
Mailing address:
  • Phone: 515-639-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number097017
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: