Provider Demographics
NPI:1225067150
Name:AZAD, LEILA (DDS)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:AZAD
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 1:180 MONTGOMERY ST STE 2440
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4258
Mailing Address - Country:US
Mailing Address - Phone:415-398-4110
Mailing Address - Fax:415-398-4195
Practice Address - Street 1:180 MONTGOMERY ST STE 2440
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-4258
Practice Address - Country:US
Practice Address - Phone:415-398-4110
Practice Address - Fax:415-398-4195
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice