Provider Demographics
NPI:1871506188
Name:OAKES, LESLIE ANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ANNE
Last Name:OAKES
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 1:618TH DENTAL COMPANY AS USA DENTAC K
Mailing Address - Street 2:UNIT #15652
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-5652
Mailing Address - Country:US
Mailing Address - Phone:315-737-9061
Mailing Address - Fax:
Practice Address - Street 1:4TH INNER LOOP
Practice Address - Street 2:
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310
Practice Address - Country:US
Practice Address - Phone:503-440-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9001122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist