Healthcare Provider Details

I. General information

NPI: 1356279319
Provider Name (Legal Business Name): DR. VIKTORIA M LEONARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E MAIN ST STE E
JACKSON OH
45640-1786
US

IV. Provider business mailing address

345 E MAIN ST STE E
JACKSON OH
45640-1786
US

V. Phone/Fax

Practice location:
  • Phone: 740-288-0208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.028430
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: