Provider Demographics
NPI:1558036012
Name:LAHHAM, LEANNA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LEANNA
Middle Name:
Last Name:LAHHAM
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 1:19726 LASSEN ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-5647
Mailing Address - Country:US
Mailing Address - Phone:818-926-3686
Mailing Address - Fax:
Practice Address - Street 1:19726 LASSEN ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-5647
Practice Address - Country:US
Practice Address - Phone:818-926-3686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106770122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist