Provider Demographics
NPI:1134805153
Name:LEONARD, JONATHAN FRANCIS (DMD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:FRANCIS
Last Name:LEONARD
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 1:702 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANDIS
Mailing Address - State:NC
Mailing Address - Zip Code:28088-1706
Mailing Address - Country:US
Mailing Address - Phone:203-788-8357
Mailing Address - Fax:
Practice Address - Street 1:702 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LANDIS
Practice Address - State:NC
Practice Address - Zip Code:28088-1706
Practice Address - Country:US
Practice Address - Phone:704-857-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC136991223G0001X
OK77741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice