Provider Demographics
NPI:1033328547
Name:WEINSTEIN, LEOPOLD (DDS)
Entity Type:Individual
Prefix:
First Name:LEOPOLD
Middle Name:
Last Name:WEINSTEIN
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 1:2438 N PONDEROSA DR
Mailing Address - Street 2:SUITE C217
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010
Mailing Address - Country:US
Mailing Address - Phone:805-484-1611
Mailing Address - Fax:805-482-1069
Practice Address - Street 1:2438 N PONDEROSA DR
Practice Address - Street 2:SUITE C217
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010
Practice Address - Country:US
Practice Address - Phone:805-484-1611
Practice Address - Fax:805-482-1069
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice