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General NPI Number Information
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NPI Number | 1235810433
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Entity Type | Individual
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Provider Name | JULIA MAI LAN LEONG DDS
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Gender | Female
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 11/24/2024
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Provider Practice Location Address
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Address Line | 1950 SUNNY CREST DR STE 3000
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City | FULLERTON
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State | CA
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Zip | 92835-3641
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Country | US
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Telephone | 714-455-3823
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Fax |
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Provider Business Mailing Address
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Address Line | 20243 ELKWOOD ST
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City | WINNETKA
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State | CA
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Zip | 91306-2313
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Country | US
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Telephone | 818-424-8477
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 108854
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 108854
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License Number State | CA
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