Provider Demographics
NPI:1215246012
Name:LEUNG, ANTHONY C (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:C
Last Name:LEUNG
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 1:1605 WOOD THRUSH TRCE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-6501
Mailing Address - Country:US
Mailing Address - Phone:502-290-8918
Mailing Address - Fax:502-290-8918
Practice Address - Street 1:1605 WOOD THRUSH TRCE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-6501
Practice Address - Country:US
Practice Address - Phone:502-290-8918
Practice Address - Fax:502-290-8918
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY79341223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics