Provider Demographics
NPI:1851546717
Name:LE, WIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WIN
Middle Name:
Last Name:LE
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 1:3122 UNION ST
Mailing Address - Street 2:CF-1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2338
Mailing Address - Country:US
Mailing Address - Phone:347-453-8417
Mailing Address - Fax:
Practice Address - Street 1:3122 UNION ST
Practice Address - Street 2:CF-1A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2338
Practice Address - Country:US
Practice Address - Phone:347-453-8417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052616122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist