Healthcare Provider Details

I. General information

NPI: 1528873916
Provider Name (Legal Business Name): LEON A WRIGHT III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 LASALLE RD SUITE 200
TOWSON MD
21286
US

IV. Provider business mailing address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

V. Phone/Fax

Practice location:
  • Phone: 443-605-6385
  • Fax:
Mailing address:
  • Phone: 434-570-0693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18572
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: