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General NPI Number Information
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NPI Number | 1013329770
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Entity Type | Individual
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Provider Name | KELLY KIMIKO LEONG DMD
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Gender | Female
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 2645 OCEAN AVE STE 203
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1646
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Country | US
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Telephone | 707-340-3886
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Fax |
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Provider Business Mailing Address
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Address Line | 3145 GEARY BLVD # 102
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3316
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Country | US
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Telephone | 707-340-3886
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DDS100461
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License Number State | CA
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