Provider Demographics
NPI:1619121811
Name:LE, HANH NGUYEN (DDS)
Entity Type:Individual
Prefix:
First Name:HANH
Middle Name:NGUYEN
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 1:1904 W PARKSIDE LN
Mailing Address - Street 2:STE. 201
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1228
Mailing Address - Country:US
Mailing Address - Phone:800-409-2563
Mailing Address - Fax:623-321-6268
Practice Address - Street 1:13935 NADIA WAY
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3623
Practice Address - Country:US
Practice Address - Phone:714-713-9008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice