Healthcare Provider Details

I. General information

NPI: 1568472876
Provider Name (Legal Business Name): LEON SIDNEY SILVERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E KEMPER RD
CINCINNATI OH
45246
US

IV. Provider business mailing address

8805 GOVERNORS HILL #105
CINCINNATI OH
45249
US

V. Phone/Fax

Practice location:
  • Phone: 513-671-6161
  • Fax: 513-697-2650
Mailing address:
  • Phone: 513-697-2640
  • Fax: 513-697-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30012969
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: