Provider Demographics
NPI:1821299249
Name:LE, UYEN PHUONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:UYEN
Middle Name:PHUONG
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 1:13106 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-3358
Mailing Address - Country:US
Mailing Address - Phone:301-879-7926
Mailing Address - Fax:301-879-7926
Practice Address - Street 1:531 S FREDERICK AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2351
Practice Address - Country:US
Practice Address - Phone:301-947-5500
Practice Address - Fax:301-947-6620
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD126491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice