Provider Demographics
NPI:1891995320
Name:LEONG, EDWARD CHIWING (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CHIWING
Last Name:LEONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 ANITA CREST DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-1608
Mailing Address - Country:US
Mailing Address - Phone:626-355-5753
Mailing Address - Fax:
Practice Address - Street 1:76 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3945
Practice Address - Country:US
Practice Address - Phone:909-946-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46199122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist