Provider Demographics
NPI:1093833931
Name:LE, LAN CHI THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAN CHI
Middle Name:THI
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6783
Mailing Address - Country:US
Mailing Address - Phone:469-326-4867
Mailing Address - Fax:
Practice Address - Street 1:9090 SKILLMAN ST
Practice Address - Street 2:SUITE 200C
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8259
Practice Address - Country:US
Practice Address - Phone:214-342-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX227551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice