Daniel Charles Leitman, DMD
Individual provider Active NPI General Practice Dentistry · Upper Monclair, NJ
NPI 1609073832 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609073832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DI021815 (NJ)
- Practice address
- 203 Bellevue Ave
Upper Monclair, NJ 07043 - Phone
- (973) 744-5466
- NPI assigned
- Jun 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI021815 | NJ | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI021815 | NJ | Yes |
Addresses
Primary practice location
203 Bellevue Ave
Upper Monclair, NJ 07043
Mailing address
185 Liberty St Apt A5
Apt 5a
Little Ferry, NJ 07643-1770
Phone (973) 953-2336
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.