Provider Demographics
NPI:1801038922
Name:LE, CHAU-BAO T (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAU-BAO
Middle Name:T
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 1:3426 ZION CANYON CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5234
Mailing Address - Country:US
Mailing Address - Phone:925-227-1616
Mailing Address - Fax:
Practice Address - Street 1:3426 ZION CANYON CT
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5234
Practice Address - Country:US
Practice Address - Phone:925-227-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice