Healthcare Provider Details

I. General information

NPI: 1326967084
Provider Name (Legal Business Name): CRUZ GREGORY LEANOS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 TWEEDY BLVD
SOUTH GATE CA
90280-6001
US

IV. Provider business mailing address

7212 MARCELLE ST
PARAMOUNT CA
90723-4811
US

V. Phone/Fax

Practice location:
  • Phone: 323-264-0205
  • Fax:
Mailing address:
  • Phone: 562-706-7026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: