Healthcare Provider Details

I. General information

NPI: 1487941795
Provider Name (Legal Business Name): LESLIE CAMILLE PINSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 HAMPTON PL
SPRINGFIELD OH
45503-2613
US

IV. Provider business mailing address

251 HAMPTON PL
SPRINGFIELD OH
45503-2613
US

V. Phone/Fax

Practice location:
  • Phone: 937-390-8740
  • Fax: 937-390-8745
Mailing address:
  • Phone: 937-390-8740
  • Fax: 937-390-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number023511
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30-023511
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: