MEDICARE: ANDREA SELINA LEAL 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	111968	CA

General Provider Information

NPI Number	:	1972460319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA SELINA LEAL DDS

Provider Business Mailing Address
First Line	:	2161 W 6TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3121
Country	:	US
Telephone Number	:	213-483-8222
Fax Number	:	213-413-0457

Provider Business Practice Location Address
First Line	:	2161 W 6TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3121
Country	:	US
Telephone Number	:	213-483-8222
Fax Number	:	213-413-0457

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

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “ ANDREA SELINA LEAL DDS” Practice Location

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