Provider Demographics
NPI:1659801694
Name:GRIFFIN, LEIGH (DDS)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:GRIFFIN
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 1:520 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5064
Mailing Address - Country:US
Mailing Address - Phone:804-828-1778
Mailing Address - Fax:804-828-6234
Practice Address - Street 1:520 N 12TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5064
Practice Address - Country:US
Practice Address - Phone:804-828-1778
Practice Address - Fax:804-828-6234
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1230271223P0106X
LA67611223P0106X
MADN18599431223P0106X
VA04014197811223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA6761OtherSTATE LICENSE