Provider Demographics
NPI:1578946620
Name:WINKLER, LEEANN (RDH)
Entity Type:Individual
Prefix:MRS
First Name:LEEANN
Middle Name:
Last Name:WINKLER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 TEALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2676
Mailing Address - Country:US
Mailing Address - Phone:972-839-7511
Mailing Address - Fax:
Practice Address - Street 1:824 TEALWOOD DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-2676
Practice Address - Country:US
Practice Address - Phone:972-839-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5194124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist