Provider Demographics
NPI:1609230523
Name:THUY BICH LE, DDS, INC
Entity Type:Organization
Organization Name:THUY BICH LE, DDS, INC
Other - Org Name:TITAN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THUY
Authorized Official - Middle Name:BICH
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-990-3321
Mailing Address - Street 1:391 S STATE COLLEGE BLVD
Mailing Address - Street 2:SUITE M
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5755
Mailing Address - Country:US
Mailing Address - Phone:714-990-3321
Mailing Address - Fax:714-990-3546
Practice Address - Street 1:391 S STATE COLLEGE BLVD
Practice Address - Street 2:SUITE M
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5755
Practice Address - Country:US
Practice Address - Phone:714-990-3321
Practice Address - Fax:714-990-3546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49357122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty