Provider Demographics
NPI:1639351653
Name:ORDAZ, LEONOR (DDS)
Entity Type:Individual
Prefix:
First Name:LEONOR
Middle Name:
Last Name:ORDAZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573
Mailing Address - Country:US
Mailing Address - Phone:914-937-6788
Mailing Address - Fax:914-239-3016
Practice Address - Street 1:216 WESTCHESTER AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573
Practice Address - Country:US
Practice Address - Phone:914-937-6788
Practice Address - Fax:914-239-3016
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04567911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice