Individual provider Active NPI

Ringo Leung, DDS

  • General Practice Dentistry
  • Munster, IN
National Provider Identifier
1629051024
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12012583A Issued in IN
Practice address
1644 45TH St
Munster, IN 46321-3970
Phone
(219) 924-2860
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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 12012583A IN Primary
Dentist 122300000X 319014278 IL

Addresses

Primary practice location

1644 45TH St
Munster, IN 46321-3970

Mailing address

1644 45TH St
Munster, IN 46321-3970
Phone (219) 924-2860

Other practice location 1

2004 N Pulaski Rd
Chicago, IL 60639-3767
Phone (773) 342-5923

Other identifiers 1

IdentifierTypeStateIssuer
1005160MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160329000516 IL Order and Referring Only - DentistPractitioner - Dentist 3274830765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
319014278ILMDDentist
12012583AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Dental Studio LLC Current Accepting new patients
Ogando DDS LLC PastSince Jun 5, 2022 Accepting new patients
West Town Dental Group Dentist Past Accepting new patients

Organizations & group practices 3

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1629051024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 45TH ST",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213970",
            "telephone_number": "219-924-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 45TH ST",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213970",
            "telephone_number": "219-924-2860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2004 N Pulaski Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606393767",
            "country_code": "US",
            "telephone_number": "773-342-5923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "RINGO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012583A",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "319014278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005160",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.