Richard Wilson Leong Jr., DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN6419 Issued in FL

Practice address

400 S Babcock St
Melbourne, FL 32901-1214

Phone

(321) 723-7255

Fax

(321) 768-9643

NPI assigned

May 4, 2007

Last updated

Jan 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richard Wilson Leong Jr DDS PA

  • General Practice Dentistry
  • Melbourne, FL
  • NPI 1821637638
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1023220803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 N RIVERSIDE DR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034422",
            "telephone_number": "321-777-5201",
            "fax_number": "321-768-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BABCOCK ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011214",
            "telephone_number": "321-723-7255",
            "fax_number": "321-768-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "RICHARD",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN6419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Lenoci, DPM
• Lorraine Lento
• Hailye Lentz
• Michael J Leon Jr.
• Michele Leone, RNFA, LMHC
• Raul Leoni, NP-C
• Samantha Lerner
• Pierre M Leroux, MD
• Leslie K McKibben RPT Assoc
• Tegan Lesperance, PH.D.

• Dentist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.