Provider Demographics
NPI:1386706513
Name:JAMES T LEON DDS INC
Entity type:Organization
Organization Name:JAMES T LEON DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-279-0641
Mailing Address - Street 1:3079 WEST BROAD STREET
Mailing Address - Street 2:SUITE #7
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204
Mailing Address - Country:US
Mailing Address - Phone:614-279-0641
Mailing Address - Fax:614-279-9875
Practice Address - Street 1:3079 WEST BROAD STREET
Practice Address - Street 2:SUITE #7
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204
Practice Address - Country:US
Practice Address - Phone:614-279-0641
Practice Address - Fax:614-279-9875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH18705122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty