Individual provider Active NPI

Nathaniel Wen-Wei Leng, D.D.S

  • General Practice Dentistry
  • Yucaipa, CA
National Provider Identifier
1194077529
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61763 Issued in CA
Practice address
34880 Yucaipa Blvd
Yucaipa, CA 92399-4235
Phone
(909) 797-1136
NPI assigned
Oct 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60308456 WA
General Practice Dentistry 1223G0001X 61763 CA Primary

Addresses

Primary practice location

34880 Yucaipa Blvd
Yucaipa, CA 92399-4235

Mailing address

34880 Yucaipa Blvd
Yucaipa, CA 92399-4235
Phone (909) 797-1136

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813012593 CA Order and Referring Only - DentistPractitioner - Dentist 5395050728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60308456WAMDGeneral Practice Dentistry
61763CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Chokka Dental Corporation General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1194077529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34880 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994235",
            "telephone_number": "909-797-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34880 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994235",
            "telephone_number": "909-797-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENG",
        "first_name": "NATHANIEL",
        "middle_name": "WEN-WEI",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-09",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60308456",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.