Provider Demographics
NPI:1831248608
Name:LE, NICKIE K (DDS)
Entity type:Individual
Prefix:DR
First Name:NICKIE
Middle Name:K
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4809 ARGONNE ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249
Mailing Address - Country:US
Mailing Address - Phone:303-578-7655
Mailing Address - Fax:303-388-0607
Practice Address - Street 1:4809 ARGONNE ST
Practice Address - Street 2:SUITE 220
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249
Practice Address - Country:US
Practice Address - Phone:303-578-7655
Practice Address - Fax:303-388-0607
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist