Provider Demographics
NPI:1134617137
Name:LE, CALVIN NGUYEN (DDS)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:NGUYEN
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 1:20355 SHAKARI CIR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-3267
Mailing Address - Country:US
Mailing Address - Phone:714-455-9194
Mailing Address - Fax:714-455-9194
Practice Address - Street 1:2 JOURNEY STE 205
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3373
Practice Address - Country:US
Practice Address - Phone:949-643-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1035891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry