Provider Demographics
NPI:1821466400
Name:MICHELLE LEONG NG, DDS, MS, PLLC
Entity Type:Organization
Organization Name:MICHELLE LEONG NG, DDS, MS, PLLC
Other - Org Name:MICHELLE KIMURA KIDS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEONG
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:212-877-3153
Mailing Address - Street 1:262 CENTRAL PARK W
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3512
Mailing Address - Country:US
Mailing Address - Phone:212-877-3153
Mailing Address - Fax:
Practice Address - Street 1:262 CENTRAL PARK W
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3512
Practice Address - Country:US
Practice Address - Phone:212-877-3153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-12
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0530171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty