Provider Demographics
NPI:1275677320
Name:GRACE, LEANA KAYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEANA
Middle Name:KAYE
Last Name:GRACE
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 1:7372 E ARCHER PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6718
Mailing Address - Country:US
Mailing Address - Phone:303-344-8020
Mailing Address - Fax:
Practice Address - Street 1:10881 W ASBURY AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-1969
Practice Address - Country:US
Practice Address - Phone:303-989-0452
Practice Address - Fax:720-962-8667
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO90761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice