Provider Demographics
NPI:1417057092
Name:LE, JULIA LUU (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:LUU
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:CHU
Other - Last Name:LUU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:28 BRANDERMILL DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-6600
Mailing Address - Country:US
Mailing Address - Phone:702-665-5013
Mailing Address - Fax:702-665-4065
Practice Address - Street 1:1720 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-4896
Practice Address - Country:US
Practice Address - Phone:702-665-5013
Practice Address - Fax:702-665-4065
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4585T122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100504015Medicaid