Provider Demographics
NPI:1487684791
Name:DEAN, LESLIE P (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:P
Last Name:DEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 PIPER ST
Mailing Address - Street 2:SUITE S-220
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4672
Mailing Address - Country:US
Mailing Address - Phone:907-563-3145
Mailing Address - Fax:907-561-3967
Practice Address - Street 1:3831 PIPER ST
Practice Address - Street 2:SUITE S-220
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4672
Practice Address - Country:US
Practice Address - Phone:907-563-3145
Practice Address - Fax:907-561-3967
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3547207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD03661Medicaid
160143Medicare ID - Type Unspecified
AKMD03661Medicaid