Individual provider Active NPI

Michelle Tran Leong, DDS

  • Dentist
  • Pauma Valley, CA
National Provider Identifier
1841569738
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60642 Issued in CA
Practice address
16650 Highway 76
Pauma Valley, CA 92061-9524
Phone
(760) 742-0672
NPI assigned
Dec 21, 2011
Last updated
Dec 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60642 CA Primary

Addresses

Primary practice location

16650 Highway 76
Pauma Valley, CA 92061-9524

Mailing address

16650 Highway 76
PO Box 655
Pauma Valley, CA 92061-9524

Other names 1

  • Michelle Tran Former name

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
I20140414000564 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658503214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60642CAMDDentist

Interoperability endpoints

  • Direct secure messaging: michelle.leong@nh.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1841569738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16650 HIGHWAY 76",
            "address_2": "PO BOX 655",
            "city": "PAUMA VALLEY",
            "state": "CA",
            "postal_code": "920619524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16650 HIGHWAY 76",
            "city": "PAUMA VALLEY",
            "state": "CA",
            "postal_code": "920619524",
            "telephone_number": "760-742-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "MICHELLE",
        "middle_name": "TRAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-21",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "TRAN",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pauma Valley, CA

Sources for this page

Verify at the official NPI Registry.