DR. RICHARD D LEATHERS (NPI# 1588790307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588790307 |
| Entity Type | Individual |
| Full Name | DR. RICHARD D LEATHERS |
| Credential | DDS |
| Practice Address |
12021 Wilmington Ave Los Angeles CA 90059-3019 |
| Mailing Address |
4054 Athenian Way Los Angeles CA 90043-1618 |
| Practice Telephone | 3106684515 |
| Practice Fax Number | 3107638909 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | DK28026 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
12021 WILMINGTON AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059-3019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750351300 | Gangadarshni Chandramohan | Pediatrics | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2006-01-25 |
| 1639704323 | Martin Luther King Jr Community Medical Group-wilmington Ave | Case Manager/Care Coordinator | 12021 Wilmington Ave, Building 11, Suite 1000, Los Angeles, CA 90059 | 2020-03-03 |
| 1114418928 | Exodus Recovery, Inc. | Community/Behavioral Health | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2018-05-29 |
| 1043759855 | Los Angeles County Department of Mental Health | Clinic/Center | 12021 Wilmington Ave, Los Angeles, CA 90059 | 2017-02-14 |
| 1053855064 | Maria Casarez-romero | Rehabilitation Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-09 |
| 1295279453 | Kelsey Collins | Marriage & Family Therapist | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-07 |
| 1639628035 | Stella Cuomo | Student in an Organized Health Care Education/Training Program | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-09-26 |
| 1821443995 | Patanya Matthews | Counselor | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-04-26 |
| 1043677289 | Kita Stovall | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059 | 2016-01-19 |
| 1417314741 | Noele Le Flore | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871810846 | Nam Cho | Oral & Maxillofacial Surgery | 4040 Via Marisol, #220, Los Angeles, CA 90042-5154 | 2010-04-29 |
| 1679709075 | Steven Kupferman Dmd Md Inc | Oral & Maxillofacial Surgery | 2080 Century Park East Blvd, Suite 710, Los Angeles, CA 90067 | 2009-06-01 |
| 1851392062 | Rick Chien Chi Tsay | Oral & Maxillofacial Surgery | 10811 Ashton Ave, #308, Los Angeles, CA 90024-4878 | 2005-08-10 |
| 1780902536 | Soroush Zaghi | Oral & Maxillofacial Surgery | 10921 Wilshire Blvd, Suite 912, Los Angeles, CA 90024-3906 | 2010-05-04 |
| 1568698843 | Omar M Faridi | Oral & Maxillofacial Surgery | 1200 N State St, Ct A3c 117, Los Angeles, CA 90033-1029 | 2009-06-01 |
| 1851417737 | Vivek Shetty | Oral & Maxillofacial Surgery | 10833 Le Conte Ave, Suite Ao-156, Los Angeles, CA 90095-1668 | 2007-03-22 |
| 1346359973 | Frederick C Rutherford | Oral & Maxillofacial Surgery | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-08-29 |
| 1619084985 | Joseph Mcquirter Sr. | Oral & Maxillofacial Surgery | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457983025 | Olena Norris Dds Dental Corporation | Oral & Maxillofacial Surgery | 5060 California Ave Ste 202, Bakersfield, CA 93309-7087 | 2020-02-11 |
| 1306498829 | Henry Mayo Newhall Clinics, LLC | Oral & Maxillofacial Surgery | 25751 Mcbean Pkwy Ste 220, Valencia, CA 91355-3701 | 2019-07-15 |
| 1396211926 | Fremont Oral & Maxillofacial Surgery | Oral & Maxillofacial Surgery | 39210 State St Ste 115, Fremont, CA 94538-1456 | 2018-10-22 |
| 1013495985 | Ned L. Nix, Dds, Inc | Oral & Maxillofacial Surgery | 704 Blossom Hill Rd Ste 102, San Jose, CA 95123-5403 | 2018-08-02 |
| 1811475759 | University of California Sfgh Medical Group | Oral & Maxillofacial Surgery | 1001 Potrero Avenue, Bldg 5, Room 1n1, San Francisco, CA 94110-3518 | 2018-08-02 |
| 1235649690 | Mac Dental Corporation | Oral & Maxillofacial Surgery | 9855 Erma Road, #110, Scripps Periodontics, San Diego, CA 92131 | 2017-10-11 |
| 1710354162 | Michael J. Belton Dds,md Inc. | Oral & Maxillofacial Surgery | 2045 Compton Ave Ste 102, Corona, CA 92881-7293 | 2015-09-01 |
| 1508263740 | F.a.c.e. Surgical Center of The Desert | Oral & Maxillofacial Surgery | 1900 E Tahquitz Canyon Way Ste C4, Palm Springs, CA 92262-7062 | 2014-12-03 |
| 1407114499 | Niloofar Deyhim | Oral & Maxillofacial Surgery | 853 Middlefield Rd Ste 1, Palo Alto, CA 94301-2900 | 2012-04-26 |
| 1437479144 | Brian Robert Carr | Oral & Maxillofacial Surgery | 521 Parnassus Ave # C-522, San Francisco, CA 94143-0440 | 2010-06-03 |
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| City | LOS ANGELES |
| Zip Code | 90059 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.