Provider Demographics
NPI:1821658774
Name:IVANE LE-NGUYEN DMD INC
Entity Type:Organization
Organization Name:IVANE LE-NGUYEN DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IVANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LE-NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-622-5593
Mailing Address - Street 1:250 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3953
Mailing Address - Country:US
Mailing Address - Phone:714-622-5593
Mailing Address - Fax:
Practice Address - Street 1:250 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3953
Practice Address - Country:US
Practice Address - Phone:714-622-5593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental