MEDICARE: LE DENTAL GROUP PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1508710617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LE DENTAL GROUP PLLC

Provider Business Mailing Address
First Line	:	4330 HIGHWAY 6 N STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-3447
Country	:	US
Telephone Number	:	650-267-1797
Fax Number	:

Provider Business Practice Location Address
First Line	:	4330 HIGHWAY 6 N STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-3447
Country	:	US
Telephone Number	:	650-267-1797
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRYAN LE
Credential	:	DDS
Telephone Number	:	650-267-1797

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	02/25/2026

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