Provider Demographics
NPI:1093448292
Name:LE, HUYEN (DDS)
Entity Type:Individual
Prefix:
First Name:HUYEN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HUYEN
Other - Middle Name:THI DIEU
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:480 E FREMONT PL UNIT 403
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18525 E SMOKY HILL RD STE D
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3109
Practice Address - Country:US
Practice Address - Phone:303-502-1178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00205178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist