Provider Demographics
NPI:1093900474
Name:LEORDEANU, MIHAELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIHAELA
Middle Name:
Last Name:LEORDEANU
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 1:4515 POPLAR AVE.
Mailing Address - Street 2:STE. 227
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-7517
Mailing Address - Country:US
Mailing Address - Phone:901-680-9578
Mailing Address - Fax:
Practice Address - Street 1:4515 POPLAR AVE
Practice Address - Street 2:STE. 227
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-7503
Practice Address - Country:US
Practice Address - Phone:901-680-9578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000070211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice