Provider Demographics
NPI:1578500773
Name:MCCLESKEY, SHIRLEY LEUNG (DDS)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:LEUNG
Last Name:MCCLESKEY
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 1:2239 S CARAWAY RD
Mailing Address - Street 2:SUITE S
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-6204
Mailing Address - Country:US
Mailing Address - Phone:870-935-0242
Mailing Address - Fax:870-935-4058
Practice Address - Street 1:2239 S CARAWAY RD
Practice Address - Street 2:SUITE S
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6204
Practice Address - Country:US
Practice Address - Phone:870-935-0242
Practice Address - Fax:870-935-4058
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR27851223G0001X
TNDS00000048761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR117466OtherUNITED CONCORDIA COMPANY
AR59278OtherAR BLUECROSS BLUESHIELD