Provider Demographics
NPI:1396303269
Name:LEONARD, SIMONE NASSIM KALHORN (DDS)
Entity type:Individual
Prefix:DR
First Name:SIMONE
Middle Name:NASSIM KALHORN
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SIMONE
Other - Middle Name:NASSIM
Other - Last Name:KALHORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5850 OLD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-3950
Mailing Address - Country:US
Mailing Address - Phone:719-210-9997
Mailing Address - Fax:
Practice Address - Street 1:935 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4876
Practice Address - Country:US
Practice Address - Phone:719-210-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204018122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODEN.00204018OtherCOLORADO LICENSE