Eden Leonard, DDS
Individual provider Active NPI Dentist · Calumet, MI
NPI 1841035474 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1841035474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901602230 (MI)
- Practice address
- 56720 Calumet Ave
Calumet, MI 49913-1904 - Phone
- (906) 483-1177
- NPI assigned
- Jun 26, 2024
- Sex
- Female
- 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 |
|---|---|---|---|
| 2901602230 | MI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901602230 | MI | Yes |
Addresses
Primary practice location
56720 Calumet Ave
Calumet, MI 49913-1904
Mailing address
56720 Calumet Ave
Calumet, MI 49913-1904
Phone (906) 483-1177
Other providers in Calumet, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2024. 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.