MEDICARE: DR. JOSEPH RICHARD LEON D.M.D.

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	21226	OH

General Provider Information

NPI Number	:	1760566798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH RICHARD LEON D.M.D.

Provider Business Mailing Address
First Line	:	6009 LANDERHAVEN DR STE E
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4192
Country	:	US
Telephone Number	:	440-720-0544
Fax Number	:	440-720-0846

Provider Business Practice Location Address
First Line	:	6009 LANDERHAVEN DR STE E
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4192
Country	:	US
Telephone Number	:	440-720-0544
Fax Number	:	440-720-0846

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	05/01/2023

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