Provider Demographics
NPI:1073745584
Name:LEUNG, HERMAN (DDS)
Entity Type:Individual
Prefix:
First Name:HERMAN
Middle Name:
Last Name:LEUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 S ZEDIKER AVE
Mailing Address - Street 2:
Mailing Address - City:PARLIER
Mailing Address - State:CA
Mailing Address - Zip Code:93648-2639
Mailing Address - Country:US
Mailing Address - Phone:559-646-3561
Mailing Address - Fax:559-646-6906
Practice Address - Street 1:545 E MANNING AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:PARLIER
Practice Address - State:CA
Practice Address - Zip Code:93648-2652
Practice Address - Country:US
Practice Address - Phone:559-646-3561
Practice Address - Fax:559-646-6906
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58668122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA58668OtherDENTAL BOARD OF CALIFORNIA