Provider Demographics
NPI:1699459073
Name:READY, LEA MARI (DMD)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:MARI
Last Name:READY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4584 W HAZEL LN
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-0121
Mailing Address - Country:US
Mailing Address - Phone:408-402-1861
Mailing Address - Fax:
Practice Address - Street 1:20826 E RIGGS RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-7324
Practice Address - Country:US
Practice Address - Phone:480-382-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011784122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist