Provider Demographics
NPI:1730318726
Name:LEUNG, TIFFANY KATIE (DDS)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:KATIE
Last Name:LEUNG
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 1:9 SHORESIDE DR
Mailing Address - Street 2:
Mailing Address - City:S BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5310
Mailing Address - Country:US
Mailing Address - Phone:847-426-3333
Mailing Address - Fax:
Practice Address - Street 1:9 SHORESIDE DR
Practice Address - Street 2:
Practice Address - City:S BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5310
Practice Address - Country:US
Practice Address - Phone:847-426-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.028041122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist