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NPI Code Detail

MEDICARE: DR. VANESSA LEON DDS

MEDICARE: DR. VANESSA LEON DDS
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
1122300000XDentistDN21904FL

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 : 1245682210
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VANESSA LEON DDS
Provider Business Mailing Address
First Line : 7326 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-6055
Country : US
Telephone Number : 407-658-4060
Fax Number : 407-658-4062
Provider Business Practice Location Address
First Line : 7326 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-6055
Country : US
Telephone Number : 407-658-4060
Fax Number : 407-658-4062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2016
Last Update Date : 02/15/2017

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Directions to “ DR. VANESSA LEON DDS” Practice Location

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