Healthcare Provider Details

I. General information

NPI: 1508268103
Provider Name (Legal Business Name): LENG C. HAONG, D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2014
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5867 LONE TREE WAY STE F
ANTIOCH CA
94531-8623
US

IV. Provider business mailing address

5867 LONE TREE WAY STE F
ANTIOCH CA
94531-8623
US

V. Phone/Fax

Practice location:
  • Phone: 925-732-4628
  • Fax: 925-779-1407
Mailing address:
  • Phone: 925-732-4628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number50265
License Number StateCA

VIII. Authorized Official

Name: DR. LENG CHUNG HAONG
Title or Position: PRESIDENT
Credential: DDS
Phone: 714-578-6358