Healthcare Provider Details

I. General information

NPI: 1972127538
Provider Name (Legal Business Name): YEN LE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14314 RAMONA BLVD
BALDWIN PARK CA
91706-3241
US

IV. Provider business mailing address

17269 BLUE SPRUCE LN
YORBA LINDA CA
92886-1865
US

V. Phone/Fax

Practice location:
  • Phone: 909-869-0250
  • Fax:
Mailing address:
  • Phone: 714-944-0569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDDS107251
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: