Provider Demographics
NPI:1518944479
Name:TANIMURA, LESLIE KYOKO (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:KYOKO
Last Name:TANIMURA
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Gender:F
Credentials:DDS MSD
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Mailing Address - Street 1:2390 COUNTRY HILLS DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:925-757-4220
Mailing Address - Fax:925-757-5457
Practice Address - Street 1:2390 COUNTRY HILLS DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-757-4220
Practice Address - Fax:925-757-5457
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2010-03-29
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Provider Licenses
StateLicense IDTaxonomies
CA393441223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry