A Street Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9810 Issued in WA

Legal business name

A STREET DENTAL CLINIC

Practice address

902 A St SE
Suite a
Auburn, WA 98002-6056

Phone

(253) 288-9608

Fax

(253) 288-9631

NPI assigned

Oct 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin C Leung, D.D.S.NPI 1699850743

Title

Practice Owner/Dentist

Phone

(253) 288-9608

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin C. Leung, D.D.S.

  • General Practice Dentistry
  • Auburn, WA
  • NPI 1699850743
  NPD (past) Authorized official
• Uyen C Tran, D.D.S.

  • General Practice Dentistry
  • Auburn, WA
  • NPI 1427133495
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083799068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 294TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980233542",
            "telephone_number": "253-288-9608",
            "fax_number": "253-288-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 A ST SE",
            "address_2": "SUITE A",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026056",
            "telephone_number": "253-288-9608",
            "fax_number": "253-288-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A STREET DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEUNG",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE OWNER/DENTIST",
        "authorized_official_telephone_number": "253-288-9608",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5040621",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Auburn, WA
• Providers in Auburn, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.