Provider Demographics
NPI:1235745357
Name:HA, BINH LE (DDS)
Entity Type:Individual
Prefix:
First Name:BINH
Middle Name:LE
Last Name:HA
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 1:17367 KERSHAW ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3345
Mailing Address - Country:US
Mailing Address - Phone:586-383-0084
Mailing Address - Fax:
Practice Address - Street 1:33533 W 12 MILE RD STE 150
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-5600
Practice Address - Country:US
Practice Address - Phone:888-833-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016006401223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice