Provider Demographics
NPI:1013148220
Name:LE, BICH NGOC, DDS INC
Entity Type:Organization
Organization Name:LE, BICH NGOC, DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BICH
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-531-2577
Mailing Address - Street 1:14364 BROOKHURST ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4608
Mailing Address - Country:US
Mailing Address - Phone:714-531-2577
Mailing Address - Fax:714-531-2279
Practice Address - Street 1:14364 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4608
Practice Address - Country:US
Practice Address - Phone:714-531-2577
Practice Address - Fax:714-531-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD42676122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG91359-02OtherDENTI-CAL
CA1447455431OtherINDIVIDUAL NPI
CA1689716367OtherOTHER OFFICE LOCATION FOR LE, BICH NGOC, DDS INC