Provider Demographics
NPI:1467101477
Name:AMANDA F LEONG DDS PC
Entity Type:Organization
Organization Name:AMANDA F LEONG DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OFFICIER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:FUNG
Authorized Official - Last Name:LEONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-523-7600
Mailing Address - Street 1:2215 SANTA CLARA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4416
Mailing Address - Country:US
Mailing Address - Phone:510-523-7600
Mailing Address - Fax:510-865-1179
Practice Address - Street 1:2215 SANTA CLARA AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4416
Practice Address - Country:US
Practice Address - Phone:510-523-7600
Practice Address - Fax:510-865-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty