Provider Demographics
NPI:1134276124
Name:LE, SUONG THI-TUYET (DDS)
Entity type:Individual
Prefix:DR
First Name:SUONG
Middle Name:THI-TUYET
Last Name:LE
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 STORY RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-1668
Mailing Address - Country:US
Mailing Address - Phone:408-240-9000
Mailing Address - Fax:
Practice Address - Street 1:2048 STORY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1668
Practice Address - Country:US
Practice Address - Phone:408-240-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARD52747OtherDENT-CAL