Provider Demographics
NPI:1932235116
Name:LEONE, SALVATORE ANTHONY (DDS)
Entity type:Individual
Prefix:
First Name:SALVATORE
Middle Name:ANTHONY
Last Name:LEONE
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 1:13440 NE 148TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-4612
Mailing Address - Country:US
Mailing Address - Phone:425-478-7181
Mailing Address - Fax:425-896-8273
Practice Address - Street 1:10814 19TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-5153
Practice Address - Country:US
Practice Address - Phone:425-337-4734
Practice Address - Fax:425-316-8652
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000059031223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics