Provider Demographics
NPI:1740286095
Name:BECKHAM, LEONARD DOUGLAS (DMD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:DOUGLAS
Last Name:BECKHAM
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 1:3144 IRIS DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5079
Mailing Address - Country:US
Mailing Address - Phone:205-447-1949
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ALABAMA SCHOOL OF DENTISTRY
Practice Address - Street 2:1919 7TH AVENUE, SOUTH
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-5079
Practice Address - Country:US
Practice Address - Phone:205-934-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009952140Medicaid