Active NPI
Kevin Leong
- General Practice Dentistry
- Surprise, AZ
National Provider Identifier
1629437991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D011885
- Practice address
- 14815 W Bell Rd Ste 202
Surprise, AZ 85374-7611 - Phone
- (623) 547-5400
- NPI assigned
- Feb 15, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | D011885 | AZ | Primary |
Addresses
Primary practice location
14815 W Bell Rd Ste 202
Surprise, AZ 85374-7611
Mailing address
1111 N Charles St
Baltimore, MD 21201-5505
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 |
|---|---|---|---|
| D011885 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755734400000",
"number": "1629437991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212015505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14815 W BELL RD STE 202",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853747611",
"telephone_number": "623-547-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONG",
"first_name": "KEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-15",
"last_updated": "2025-08-21",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D011885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.