Provider Demographics
NPI:1457669442
Name:STEPHENS, LEIGH ANNE (DMD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANNE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9085 E MISSISSIPPI AVE
Mailing Address - Street 2:APT. M103
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2068
Mailing Address - Country:US
Mailing Address - Phone:662-279-4148
Mailing Address - Fax:
Practice Address - Street 1:10650 GARDEN DR
Practice Address - Street 2:SUITE 106
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-7018
Practice Address - Country:US
Practice Address - Phone:303-366-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO102821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice