Provider Demographics
NPI:1235528175
Name:YEN P. LE, DDS, INC
Entity Type:Organization
Organization Name:YEN P. LE, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:YEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-459-4320
Mailing Address - Street 1:9225 MIRA MESA BLVD,
Mailing Address - Street 2:206
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126
Mailing Address - Country:US
Mailing Address - Phone:858-695-8851
Mailing Address - Fax:
Practice Address - Street 1:9225 MIRA MESA BLVD
Practice Address - Street 2:206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4820
Practice Address - Country:US
Practice Address - Phone:858-695-8851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty