Provider Demographics
NPI:1972030518
Name:ESTHER KIM LE RDHAP, INC
Entity Type:Organization
Organization Name:ESTHER KIM LE RDHAP, INC
Other - Org Name:SMILE OF HOPE DENTAL HYGIENE PRACTICE OF ESTHER KIM LE, RDHAP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:714-260-2259
Mailing Address - Street 1:PO BOX 4772
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92842-4772
Mailing Address - Country:US
Mailing Address - Phone:714-260-2259
Mailing Address - Fax:
Practice Address - Street 1:15251 KENSINGTON PARK DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1807
Practice Address - Country:US
Practice Address - Phone:714-260-2259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-14
Last Update Date:2017-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA616261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1467721357Medicaid