Provider Demographics
NPI:1417022328
Name:G LARRY LEONAKIS DDS INC
Entity Type:Organization
Organization Name:G LARRY LEONAKIS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:LEONAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-882-0635
Mailing Address - Street 1:371 SOUTH ROOP STREET
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701
Mailing Address - Country:US
Mailing Address - Phone:775-882-0635
Mailing Address - Fax:775-882-3420
Practice Address - Street 1:371 SOUTH ROOP STREET
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701
Practice Address - Country:US
Practice Address - Phone:775-882-0635
Practice Address - Fax:775-882-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty