Provider Demographics
NPI:1801896964
Name:GOLDSMITH, LEONARD HARRY (DDS)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:HARRY
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RUNNING BROOK CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1637
Mailing Address - Country:US
Mailing Address - Phone:410-561-7277
Mailing Address - Fax:
Practice Address - Street 1:1119 MERRITT BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-1438
Practice Address - Country:US
Practice Address - Phone:410-284-9400
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD59031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDL970OtherBLUE CROSS/ BLUE SHIELD