Provider Demographics
NPI:1942443502
Name:LENEAVE, CHRISTOPHER MYERS (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MYERS
Last Name:LENEAVE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 BRECKENRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2130
Mailing Address - Country:US
Mailing Address - Phone:502-499-9999
Mailing Address - Fax:
Practice Address - Street 1:3000 BRECKENRIDGE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2130
Practice Address - Country:US
Practice Address - Phone:502-499-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6641122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist