Provider Demographics
NPI:1689938920
Name:LENARD, REBECCA (DMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:LENARD
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 1:1340 S DIXIE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2983
Mailing Address - Country:US
Mailing Address - Phone:786-673-5252
Mailing Address - Fax:
Practice Address - Street 1:1340 S DIXIE HWY STE 100
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2983
Practice Address - Country:US
Practice Address - Phone:786-673-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2023-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20020122300000X
FLDN200201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist