Active NPI
Benjamin Leung, DDS
- Oral & Maxillofacial Surgery (D.M.D.)
- West Covina, CA
National Provider Identifier
1316612518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- DR61476522
- Practice address
- 2916 E Cortez St
West Covina, CA 91791-2941 - Phone
- (909) 247-0842
- NPI assigned
- Aug 11, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS106715 | CA | |
| Dentist | 122300000X | DDS106715 | CA | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | DR61476522 | WA | Primary |
Addresses
Primary practice location
2916 E Cortez St
West Covina, CA 91791-2941
Mailing address
1959 NE Pacific Street Box 357134
Seattle, WA 98195-0001
Phone (909) 247-0842
Other practice location 1
1959 NE Pacific St
Seattle, WA 98195-2941
Phone (909) 247-0842
Other practice location 2
155 N Fresno St
Fresno, CA 93701-2302
Phone (559) 459-4182
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
| License | State | Type | Specialty |
|---|---|---|---|
| DDS106715 | CA | MD | General Practice Dentistry |
| DR61476522 | WA | MD | Oral & Maxillofacial Surgery (D.M.D.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711670400000",
"number": "1316612518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC STREET BOX 357134",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950001",
"telephone_number": "909-247-0842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2916 E CORTEZ ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917912941",
"telephone_number": "909-247-0842"
}
],
"practiceLocations": [
{
"address_1": "1959 NE Pacific St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981952941",
"country_code": "US",
"telephone_number": "909-247-0842",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "155 N Fresno St",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937012302",
"country_code": "US",
"telephone_number": "559-459-4182",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEUNG",
"first_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-11",
"last_updated": "2024-03-29",
"certification_date": "2024-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS106715",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS106715",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "WA",
"license": "DR61476522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.