Provider Demographics
NPI:1154054062
Name:LEONG, WENG YAN (DDS)
Entity Type:Individual
Prefix:
First Name:WENG
Middle Name:YAN
Last Name:LEONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 S KINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4109
Mailing Address - Country:US
Mailing Address - Phone:925-247-4954
Mailing Address - Fax:
Practice Address - Street 1:12501 E LINCOLN AVE UNIT 102
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-4753
Practice Address - Country:US
Practice Address - Phone:303-768-8137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00205259122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist