Provider Demographics
NPI:1760603526
Name:LEON, CARLOS F (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:F
Last Name:LEON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-1428
Mailing Address - Country:US
Mailing Address - Phone:714-535-7373
Mailing Address - Fax:714-535-7384
Practice Address - Street 1:1160 N EAST ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-1428
Practice Address - Country:US
Practice Address - Phone:714-535-7373
Practice Address - Fax:714-535-7384
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA544171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics