MEDICARE: DR. LEONID R BRISKIN 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	1223G0001X	General Practice Dentistry	DN15609	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1467571158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONID R BRISKIN DMD

Provider Business Mailing Address
First Line	:	8320 W SUNRISE BLVD STE 110
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33322-5434
Country	:	US
Telephone Number	:	954-475-8100
Fax Number	:	954-475-4072

Provider Business Practice Location Address
First Line	:	8320 W SUNRISE BLVD STE 110
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33322-5434
Country	:	US
Telephone Number	:	954-475-8100
Fax Number	:	954-475-4072

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	11/12/2025

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