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NPI Code Detail

MEDICARE: DR. GLADIS Z LEON D.D.S.

MEDICARE: DR. GLADIS Z LEON D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry35937CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235119512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLADIS Z LEON D.D.S.
Provider Business Mailing Address
First Line : 11009 BURBANK BLVD
Second Line : SUITE 119
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-2480
Country : US
Telephone Number : 818-762-8983
Fax Number : 818-762-7605
Provider Business Practice Location Address
First Line : 11009 BURBANK BLVD
Second Line : SUITE 119
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-2480
Country : US
Telephone Number : 818-762-8983
Fax Number : 818-762-7605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 07/09/2007

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