Provider Demographics
NPI:1457647265
Name:LEOWENAS, JULIA (DMD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:LEOWENAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:BEWLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:495 BRICKELL AVE APT 2610
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2789
Mailing Address - Country:US
Mailing Address - Phone:407-694-6524
Mailing Address - Fax:
Practice Address - Street 1:2870 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5695
Practice Address - Country:US
Practice Address - Phone:407-694-6524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL193501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice