Provider Demographics
NPI:1487761086
Name:LEIKIN, STEVEN J (DDS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:LEIKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5399 E COUNTY HIGHWAY 30A
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-6717
Mailing Address - Country:US
Mailing Address - Phone:561-676-7942
Mailing Address - Fax:850-231-2712
Practice Address - Street 1:5399 E COUNTY HIGHWAY 30A
Practice Address - Street 2:SUITE 1
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-6717
Practice Address - Country:US
Practice Address - Phone:561-676-7942
Practice Address - Fax:850-231-2712
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL90261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice