Healthcare Provider Details

I. General information

NPI: 1669239604
Provider Name (Legal Business Name): CHRISTOPHER LEPORE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06032-1956
US

IV. Provider business mailing address

7 ROYAL HUNT LN
PITTSFORD NY
14534-9744
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-2207
  • Fax:
Mailing address:
  • Phone: 585-645-8476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number064759
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number84830
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: