MEDICARE: HO-YIN LEUNG DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1223G0001X	General Practice Dentistry
2	1223P0221X	Pediatric Dentistry
3	1223P0300X	Periodontics
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
5	122300000X	Dentist

General Provider Information

NPI Number	:	1578034534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HO-YIN LEUNG DDS INC

Provider Business Mailing Address
First Line	:	4531 PHILADELPHIA ST STE B107
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2249
Country	:	US
Telephone Number	:	909-902-9110
Fax Number	:	909-902-9112

Provider Business Practice Location Address
First Line	:	4531 PHILADELPHIA ST STE B107
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2249
Country	:	US
Telephone Number	:	909-902-9110
Fax Number	:	909-902-9112

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	DR. HO-YIN LEUNG
Credential	:	DDS
Telephone Number	:	909-902-9110

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	12/16/2018

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