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:
Health care specialties
| Specialty | Code | License # | 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 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093919417 | NPPES |
| Minnesota | MEDICAID | 884127000 | |
| Minnesota | MEDICAID | 33826800 | |
| Minnesota | MEDICAID | ENROLLED |
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