Provider Demographics
NPI:1134297088
Name:LEYMAN, JOHN WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:LEYMAN
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 1:191 POMONA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3401
Mailing Address - Country:US
Mailing Address - Phone:562-682-2726
Mailing Address - Fax:714-333-4966
Practice Address - Street 1:191 POMONA AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-3401
Practice Address - Country:US
Practice Address - Phone:562-682-2726
Practice Address - Fax:714-333-4966
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276431223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA853OtherGENERAL ANESTHESIA PERMIT
CAU29093Medicare UPIN