MEDICARE: DR. DANIELLE L LEONARD 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
1	122300000X	Dentist	DDS-07802	IA
2	1223G0001X	General Practice Dentistry	DDS-07802	IA
3	1223P0221X	Pediatric Dentistry	DDS-07802	IA

General Provider Information

NPI Number	:	1730276635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE L LEONARD DDS

Provider Business Mailing Address
First Line	:	1345 E UNIVERSITY AVE
Second Line	:	#302
City	:	DES MOINES
State	:	IA
Zip	:	50316-2461
Country	:	US
Telephone Number	:	515-266-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	4090 WESTOWN PKWY STE B1
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-6760
Country	:	US
Telephone Number	:	515-267-0737
Fax Number	:	515-267-1480

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	09/17/2024

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