Provider Demographics
NPI:1134287733
Name:RAGAS, LEONIDAS J (DDS)
Entity Type:Individual
Prefix:
First Name:LEONIDAS
Middle Name:J
Last Name:RAGAS
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 1:421 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-2059
Mailing Address - Country:US
Mailing Address - Phone:630-773-9166
Mailing Address - Fax:630-773-8970
Practice Address - Street 1:421 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143-2059
Practice Address - Country:US
Practice Address - Phone:630-773-9166
Practice Address - Fax:630-773-8970
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice