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NPI Code Detail

MEDICARE: DR. LEONEL VENTON DICKEY D.D.S.

MEDICARE:  DR. LEONEL VENTON DICKEY  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 Dentistry28538CA

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 : 1487729729
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEONEL VENTON DICKEY D.D.S.
Provider Business Mailing Address
First Line : 1845 FILLMORE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3125
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1845 FILLMORE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3125
Country : US
Telephone Number : 415-567-2600
Fax Number : 415-567-2601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 11/10/2020

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Directions to “ DR. LEONEL VENTON DICKEY D.D.S.” Practice Location

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