Provider Demographics
NPI:1225276504
Name:OSTROWSKI, LEONARD WALTER III (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:WALTER
Last Name:OSTROWSKI
Suffix:III
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 1:145 GUILFORD CIR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-8023
Mailing Address - Country:US
Mailing Address - Phone:219-921-3767
Mailing Address - Fax:
Practice Address - Street 1:13721 NEWPORT AVE., SUITE 1
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780
Practice Address - Country:US
Practice Address - Phone:714-368-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist