Provider Demographics
NPI:1124166178
Name:LE, VINCENT VINH-DAO (DDS)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:VINH-DAO
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 1:3 OSBORN ST APT 110
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8601
Mailing Address - Country:US
Mailing Address - Phone:415-359-8835
Mailing Address - Fax:
Practice Address - Street 1:3 OSBORN ST APT 110
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8601
Practice Address - Country:US
Practice Address - Phone:415-359-8835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice