Provider Demographics
NPI:1588898365
Name:LEONG, ORSON K (DDS)
Entity type:Individual
Prefix:DR
First Name:ORSON
Middle Name:K
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 1:1475 CEDARWOOD LN STE B
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6128
Mailing Address - Country:US
Mailing Address - Phone:925-251-9494
Mailing Address - Fax:925-523-3186
Practice Address - Street 1:1475 CEDARWOOD LN STE B
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566
Practice Address - Country:US
Practice Address - Phone:925-251-9494
Practice Address - Fax:925-523-3186
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice