Provider Demographics
NPI:1619966868
Name:LEI, HUA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUA
Middle Name:B
Last Name:LEI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 HESTER ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4916
Mailing Address - Country:US
Mailing Address - Phone:917-376-2095
Mailing Address - Fax:212-925-6360
Practice Address - Street 1:149 HESTER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4916
Practice Address - Country:US
Practice Address - Phone:917-376-2095
Practice Address - Fax:212-925-6360
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0488131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02-110-089Medicaid