Individual provider Active NPI

Leslie C. Chow, D.M.D.

  • General Practice Dentistry
  • Pinole, CA
National Provider Identifier
1124021118
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39618 Issued in CA
Practice address
2830 Pinole Valley Rd Ste a
Pinole, CA 94564-1453
Phone
(510) 758-6684
Fax
(510) 669-2083
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39618 CA Primary

Addresses

Primary practice location

2830 Pinole Valley Rd Ste a
Pinole, CA 94564-1453

Mailing address

1250 Hercules Ave
Hercules, CA 94547-3762
Phone (510) 727-5375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39618CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124021118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HERCULES AVE",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945473762",
            "telephone_number": "510-727-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 PINOLE VALLEY RD STE A",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641453",
            "telephone_number": "510-758-6684",
            "fax_number": "510-669-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOW",
        "first_name": "LESLIE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.