Provider Demographics
NPI:1134554926
Name:LE, BELINDA (DDS)
Entity type:Individual
Prefix:DR
First Name:BELINDA
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 14 ST N
Mailing Address - Street 2:
Mailing Address - City:LETHBRIDGE
Mailing Address - State:AB
Mailing Address - Zip Code:T1H 2W7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15208 MAIN ST E
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-2638
Practice Address - Country:US
Practice Address - Phone:253-891-9100
Practice Address - Fax:253-863-9368
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE604084191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice