Provider Demographics
NPI:1972653707
Name:LE, ANH QT
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:QT
Last Name:LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 STORY RD.
Mailing Address - Street 2:SUITE 50
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-2615
Mailing Address - Country:US
Mailing Address - Phone:408-929-9797
Mailing Address - Fax:408-929-9097
Practice Address - Street 1:2811 STORY RD.
Practice Address - Street 2:SUITE 50
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127
Practice Address - Country:US
Practice Address - Phone:408-929-9797
Practice Address - Fax:408-929-9097
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice