Healthcare Provider Details

I. General information

NPI: 1578034534
Provider Name (Legal Business Name): HO-YIN LEUNG DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4531 PHILADELPHIA ST STE B107
CHINO CA
91710-2249
US

IV. Provider business mailing address

4531 PHILADELPHIA ST STE B107
CHINO CA
91710-2249
US

V. Phone/Fax

Practice location:
  • Phone: 909-902-9110
  • Fax: 909-902-9112
Mailing address:
  • Phone: 909-902-9110
  • Fax: 909-902-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. HO-YIN LEUNG
Title or Position: PRACTICE OWNER
Credential: DDS
Phone: 909-902-9110