Provider Demographics
NPI:1043411812
Name:SEKIMOTO, LEIGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:
Last Name:SEKIMOTO
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 1:4308W MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2727
Mailing Address - Country:US
Mailing Address - Phone:818-559-7600
Mailing Address - Fax:
Practice Address - Street 1:3459 CAHUENGA BLVD W
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1338
Practice Address - Country:US
Practice Address - Phone:323-876-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice