Provider Demographics
NPI:1376737940
Name:LE, LAN P (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAN
Middle Name:P
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 1:6922 LITTLE RIVER TPKE STE A
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3285
Mailing Address - Country:US
Mailing Address - Phone:703-256-1160
Mailing Address - Fax:
Practice Address - Street 1:6922 LITTLE RIVER TPKE STE A
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3285
Practice Address - Country:US
Practice Address - Phone:703-256-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice