Leonard J. Petitti, DDS, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

30739 Issued in CA

Legal business name

LEONARD J. PETITTI, DDS, INC

Practice address

12587 Hesperia Rd
Victorville, CA 92395-5847

Phone

(176) 024-1708

NPI assigned

Jan 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leonard Joseph Petitti, DDS

Title

Owner

Phone

(760) 241-7084

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184777146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12587 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955847",
            "telephone_number": "176-024-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12587 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955847",
            "telephone_number": "176-024-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD J. PETITTI, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETITTI",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "17602417084",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "30739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dedra Y Lewis, COTA/L

• Dentist in Victorville, CA
• Providers in Victorville, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.