Individual provider Active NPI

Christine P. Leung, D.D.S.

  • Dentist
  • Glendale, CA
National Provider Identifier
1962883843
Registry record updated Jul 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100765 Issued in CA
Practice address
801 S Chevy Chase Dr Ste 250
Glendale, CA 91205
Phone
(818) 265-2264
NPI assigned
Jun 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100765 CA Primary

Addresses

Primary practice location

801 S Chevy Chase Dr Ste 250
Glendale, CA 91205

Mailing address

801 S Chevy Chase Dr Ste 250
Glendale, CA 91205-4433
Phone (818) 265-2264

Other practice location 1

1704 Colorado Blvd
Eagle Rock, CA 90041-1338
Phone (323) 543-2444

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161028000744 CA Order and Referring Only - Other (Non-Physician) 4587942321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100765CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532131200000",
    "number": "1962883843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054433",
            "telephone_number": "818-265-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-265-2264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1704 Colorado Blvd",
            "address_purpose": "LOCATION",
            "city": "Eagle Rock",
            "state": "CA",
            "postal_code": "900411338",
            "country_code": "US",
            "telephone_number": "323-543-2444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "CHRISTINE",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2018-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.