Provider Demographics
NPI:1558476770
Name:SHENFIELD, LELAND WALKER (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:LELAND
Middle Name:WALKER
Last Name:SHENFIELD
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Gender:M
Credentials:DDS, MSD
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Mailing Address - Street 1:16030 BOTHELL EVERETT HWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1741
Mailing Address - Country:US
Mailing Address - Phone:425-338-9773
Mailing Address - Fax:425-338-9743
Practice Address - Street 1:16030 BOTHELL EVERETT HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1741
Practice Address - Country:US
Practice Address - Phone:425-338-9773
Practice Address - Fax:425-338-9743
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
WADE000088501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5036645Medicaid
WABS6944448OtherDEA