Individual provider Active NPI

Wayne S. H. Leong, D.D.S.

  • General Practice Dentistry
  • Hilo, HI
National Provider Identifier
1417952383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT-1687 Issued in HI
Practice address
82 Puuhonu PL
Ste 201
Hilo, HI 96720-2010
Phone
(808) 935-3552
Fax
(808) 935-0241
NPI assigned
Jun 16, 2005
Last updated
Jul 8, 2007By the provider in NPPES
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 DT-1687 HI Primary

Addresses

Primary practice location

82 Puuhonu PL
Ste 201
Hilo, HI 96720-2010

Mailing address

82 Puuhonu PL
Ste 201
Hilo, HI 96720-2010
Phone (808) 935-3552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20150303002302 HI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8628394996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT-1687HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne S H Leong, DDS, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417952383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 PUUHONU PL",
            "address_2": "STE 201",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202010",
            "telephone_number": "808-935-3552",
            "fax_number": "808-935-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PUUHONU PL",
            "address_2": "STE 201",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202010",
            "telephone_number": "808-935-3552",
            "fax_number": "808-935-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "WAYNE",
        "middle_name": "S. H.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-1687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.