Provider Demographics
NPI:1225998339
Name:ANTHONY LEITE DDS LLC
Entity type:Organization
Organization Name:ANTHONY LEITE DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:CPB, CPC, COC
Authorized Official - Phone:425-280-1542
Mailing Address - Street 1:650 E BLITHEDALE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1453
Mailing Address - Country:US
Mailing Address - Phone:415-388-6006
Mailing Address - Fax:570-508-9018
Practice Address - Street 1:650 E BLITHEDALE AVE STE A
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1453
Practice Address - Country:US
Practice Address - Phone:415-388-6006
Practice Address - Fax:570-508-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty