MEDICARE: DR. LEONARDO MIGUEL BACHOCO CASTILLO DMD

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
1	122300000X	Dentist	12013892A	IN
2	122300000X	Dentist	019034052	IL
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1396406476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARDO MIGUEL BACHOCO CASTILLO DMD

Provider Business Mailing Address
First Line	:	7135 W SAHARA AVE STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2828
Country	:	US
Telephone Number	:	630-732-1707
Fax Number	:

Provider Business Practice Location Address
First Line	:	7135 W SAHARA AVE STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2828
Country	:	US
Telephone Number	:	702-872-2872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2021
Last Update Date	:	02/06/2026

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