Leavitt, Bryce D

Leavitt, Bryce D is an sole proprietor health care provider with primary practice located at 670 S Green Valley Pkwy #15 , Henderson NV 89052. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Leavitt, Bryce D can be contacted via phone (702) 685-3700.

Contact Information

Primary practice address
670 S Green Valley Pkwy #15 Henderson NV 89052
Phone: (702) 685-3700
Fax: (702) 685-3701
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X D12476 Minnesota
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X SZ-127 Nevada
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 6227 Nevada
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 55354 Minnesota

Profile Details

NPI number 1093919417
LBN Legal business name Leavitt, Bryce D
Credentials DMD, MD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2007
Last updated Mar 19th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093919417 NPPES
Minnesota MEDICAID 884127000
Minnesota MEDICAID 33826800
Minnesota MEDICAID ENROLLED

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