Provider Demographics
NPI:1013392422
Name:JASMINE H. LE D.D.S., INC.
Entity Type:Organization
Organization Name:JASMINE H. LE D.D.S., INC.
Other - Org Name:LOS ALTOS ADVANCED DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-559-1996
Mailing Address - Street 1:166 MAIN ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-2905
Mailing Address - Country:US
Mailing Address - Phone:650-559-1996
Mailing Address - Fax:408-736-7987
Practice Address - Street 1:166 MAIN ST
Practice Address - Street 2:SUITE #1
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-2905
Practice Address - Country:US
Practice Address - Phone:650-559-1996
Practice Address - Fax:408-736-7987
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIQUE DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-27
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51956261QD0000X
CA51670261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental