Provider Demographics
NPI:1144378258
Name:ROTHENBERG, LEONARD HERBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:HERBERT
Last Name:ROTHENBERG
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 1:8970 SW 87TH CT
Mailing Address - Street 2:SUITE 21
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2207
Mailing Address - Country:US
Mailing Address - Phone:305-598-8970
Mailing Address - Fax:305-598-6302
Practice Address - Street 1:8970 SW 87TH CT
Practice Address - Street 2:SUITE 21
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2207
Practice Address - Country:US
Practice Address - Phone:305-598-8970
Practice Address - Fax:305-598-6302
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0048291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics