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General NPI Number Information
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NPI Number | 1801948864
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Entity Type | Organization
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Legal Business Name | LEONARD S. CHONG, D.D.S., INC.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 33800 ALVARADO NILES RD SUITE 1
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City | UNION CITY
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State | CA
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Zip | 94587-4359
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Country | US
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Telephone | 510-489-5671
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Fax |
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Provider Business Mailing Address
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Address Line | 33800 ALVARADO NILES RD SUITE 1
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City | UNION CITY
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State | CA
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Zip | 94587-4359
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Country | US
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Telephone | 510-489-5671
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEONARD S CHONG
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Credential | D.D.S.
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Telephone | 510-489-5671
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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 | 21555
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License Number State | CA
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