Healthcare Provider Details

I. General information

NPI: 1205008588
Provider Name (Legal Business Name): MICHAEL LEPERA DMD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 BEVERLY BLVD
LOS ANGELES CA
90057-2402
US

IV. Provider business mailing address

34 KENTWOOD RD
SUCCASUNNA NJ
07876-1406
US

V. Phone/Fax

Practice location:
  • Phone: 973-418-4887
  • Fax:
Mailing address:
  • Phone: 973-418-4887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22DI01717500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MD08262800
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC55520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: