Provider Demographics
NPI:1972946226
Name:LEACH, JAMES (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:LEACH
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 1:4725 LANKERSHIM BLVD
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1803
Mailing Address - Country:US
Mailing Address - Phone:818-766-3775
Mailing Address - Fax:
Practice Address - Street 1:4725 LANKERSHIM BLVD
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-1803
Practice Address - Country:US
Practice Address - Phone:818-766-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26195122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist