MEDICARE: DR. GIA LE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2025012470	MO

General Provider Information

NPI Number	:	1447047279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GIA LE DMD

Provider Business Mailing Address
First Line	:	209 NW MOCK AVE UNIT 2112
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2568
Country	:	US
Telephone Number	:	832-631-0053
Fax Number	:

Provider Business Practice Location Address
First Line	:	8686 E 63RD ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64133-4725
Country	:	US
Telephone Number	:	816-837-4010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2025
Last Update Date	:	04/23/2025

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Directions to “ DR. GIA LE DMD” Practice Location

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