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General NPI Number Information
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NPI Number | 1023931474
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Entity Type | Organization
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Legal Business Name | LASTING SMILES BY LEANDRA LLC
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 1547 PALOS VERDES MALL # 174
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2228
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Country | US
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Telephone | 707-595-0141
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Fax |
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Provider Business Mailing Address
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Address Line | 1547 PALOS VERDES MALL # 174
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2228
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Country | US
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Telephone | 707-595-0141
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Fax |
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Authorized Official
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Title or Position | HYGIENIST
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Name | LEANDRA SOLOMON
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Credential | RDHAP
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Telephone | 707-595-0141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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