Provider Demographics
NPI:1538904404
Name:LESHKIV, ANDRIY (DMD)
Entity type:Individual
Prefix:
First Name:ANDRIY
Middle Name:
Last Name:LESHKIV
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 1:149 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-9602
Mailing Address - Country:US
Mailing Address - Phone:215-596-9963
Mailing Address - Fax:
Practice Address - Street 1:149 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9602
Practice Address - Country:US
Practice Address - Phone:856-810-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI030298001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics