Provider Demographics
NPI:1578639829
Name:DANVILLE DENTAL RADIOLOGY
Entity Type:Organization
Organization Name:DANVILLE DENTAL RADIOLOGY
Other - Org Name:STEVEN W LEPLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LEPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RT,CRT
Authorized Official - Phone:925-831-1111
Mailing Address - Street 1:428 LA GONDA WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-2562
Mailing Address - Country:US
Mailing Address - Phone:925-831-1111
Mailing Address - Fax:925-831-8897
Practice Address - Street 1:428 LA GONDA WAY
Practice Address - Street 2:SUITE B
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-2562
Practice Address - Country:US
Practice Address - Phone:925-831-1111
Practice Address - Fax:925-831-8897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT 61423247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty