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General NPI Number Information
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NPI Number | 1033906755
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER W. LEYSTER, DDS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 4005 GRAND AVE STE B
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City | CHINO
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State | CA
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Zip | 91710-5474
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Country | US
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Telephone | 909-591-0077
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 GRAND AVE STE B
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City | CHINO
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State | CA
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Zip | 91710-5474
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PAYOR RELATIONS
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Name | MRS. CASSIE WIETH
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Credential |
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Telephone | 623-267-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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