Active NPI
Wilson Kenneth Leung, DMD
- Dentist
- Bell, CA
National Provider Identifier
1104151653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 58224
- Practice address
- 6901 South Atlantic Avenue
Bell, CA 90201 - Phone
- (323) 562-9222
- Fax
- (323) 562-9209
- NPI assigned
- Oct 15, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58224 | CA | Primary |
Addresses
Primary practice location
6901 South Atlantic Avenue
Bell, CA 90201
Mailing address
6901 South Atlantic Avenue
Bell, CA 90201
Phone (323) 562-9222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121016000676 | CA | Order and Referring Only - Oral Surgery | 5294985883 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1104151653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6901 SOUTH ATLANTIC AVENUE",
"city": "BELL",
"state": "CA",
"postal_code": "90201",
"telephone_number": "323-562-9222",
"fax_number": "323-562-9209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6901 SOUTH ATLANTIC AVENUE",
"city": "BELL",
"state": "CA",
"postal_code": "90201",
"telephone_number": "323-562-9222",
"fax_number": "323-562-9209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEUNG",
"first_name": "WILSON",
"middle_name": "KENNETH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-15",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.