Provider Demographics
NPI:1861612020
Name:NAFTALIN, LEONARD WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:WAYNE
Last Name:NAFTALIN
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 1:6323 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7581
Mailing Address - Country:US
Mailing Address - Phone:310-795-5027
Mailing Address - Fax:310-578-1647
Practice Address - Street 1:9911 W PICO BLVD STE 1450
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2713
Practice Address - Country:US
Practice Address - Phone:310-795-5027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455011223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology