Provider Demographics
NPI:1255436523
Name:LEONHART, RYAN MATTHEW (DDS)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MATTHEW
Last Name:LEONHART
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9646 W. LOOP 1604 N
Mailing Address - Street 2:SUITE 2101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254
Mailing Address - Country:US
Mailing Address - Phone:210-625-7277
Mailing Address - Fax:210-787-2022
Practice Address - Street 1:9646 W. LOOP 1604 N
Practice Address - Street 2:SUITE 2101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254
Practice Address - Country:US
Practice Address - Phone:210-625-7277
Practice Address - Fax:210-787-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX277201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery