Provider Demographics
NPI:1104940170
Name:BAROUDI, LEILA (DDS)
Entity type:Individual
Prefix:DR
First Name:LEILA
Middle Name:
Last Name:BAROUDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18805 COX AVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-6616
Mailing Address - Country:US
Mailing Address - Phone:408-866-1344
Mailing Address - Fax:408-866-1366
Practice Address - Street 1:18805 COX AVE
Practice Address - Street 2:SUITE #100
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-6616
Practice Address - Country:US
Practice Address - Phone:408-866-1344
Practice Address - Fax:408-866-1366
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice