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General NPI Number Information
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NPI Number | 1376155937
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Entity Type | Individual
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Provider Name | LEIDY SANTOS DMD
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Gender | Female
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1825 NW 167TH ST STE 109
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4838
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Country | US
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Telephone | 305-624-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 4047 SW 156TH CT
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City | MIAMI
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State | FL
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Zip | 33185-5433
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN25357
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License Number State | FL
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