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General NPI Number Information
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NPI Number | 1912046871
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Entity Type | Organization
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Legal Business Name | LEON D. ROISMAN, D.M.D., INC.
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 310 S LAKE AVE LOWER LEVEL
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City | PASADENA
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State | CA
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Zip | 91101-3540
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Country | US
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Telephone | 626-795-6855
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Fax | 626-432-4260
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Provider Business Mailing Address
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Address Line | 310 S LAKE AVE LOWER LEVEL
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City | PASADENA
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State | CA
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Zip | 91101-3540
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Country | US
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Telephone | 626-795-6855
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Fax | 626-432-4260
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. LEON D. ROISMAN
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Credential | D.M.D.
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Telephone | 626-432-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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