Provider Demographics
NPI:1073885265
Name:ZAHEDI, LEILA (DDS)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:ZAHEDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BRYANT ST
Mailing Address - Street 2:APT.3
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3601
Mailing Address - Country:US
Mailing Address - Phone:917-710-3305
Mailing Address - Fax:973-556-1269
Practice Address - Street 1:415 BRYANT ST
Practice Address - Street 2:APT.3
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-3601
Practice Address - Country:US
Practice Address - Phone:917-710-3305
Practice Address - Fax:973-556-1269
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA603841223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics