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General NPI Number Information
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NPI Number | 1114363736
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Entity Type | Individual
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Provider Name | LEONID EPSHTEYN DMD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 406 MARKET ST
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City | NANUET
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State | NY
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Zip | 10954-2744
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Country | US
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Telephone | 845-367-4180
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Fax |
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Provider Business Mailing Address
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Address Line | 10 BLUE HERON RD
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City | NANUET
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State | NY
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Zip | 10954-2435
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Country | US
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Telephone | 718-496-5687
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22DI02640300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS041057
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 058450
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License Number State | NY
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