Provider Demographics
NPI:1093913170
Name:ESPINOSA, LEONARD REYES (DMD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:REYES
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 PACIFIC AVENUE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-5322
Mailing Address - Country:US
Mailing Address - Phone:562-599-2711
Mailing Address - Fax:562-599-2671
Practice Address - Street 1:1938 PACIFIC AVENUE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5322
Practice Address - Country:US
Practice Address - Phone:562-599-2711
Practice Address - Fax:562-599-2671
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice