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General NPI Number Information
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NPI Number | 1881803468
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Entity Type | Organization
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Legal Business Name | JAMES B. LEAVITT D.M.D., P.C.
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 701 E WILCOX DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2538
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Country | US
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Telephone | 520-458-4060
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Fax | 520-458-6008
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Provider Business Mailing Address
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Address Line | 901 HEATHER DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-4934
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Country | US
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Telephone | 520-459-3209
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Fax | 520-458-6008
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Authorized Official
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Title or Position | PRESIDENT- CEO
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Name | DR. JAMES BOYD LEAVITT
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Credential | D.M.D.
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Telephone | 520-458-4060
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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 | D3698
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License Number State | AZ
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