Healthcare Provider Details
I. General information
NPI: 1184541120
Provider Name (Legal Business Name): LAN HOANG LE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14170 BROOKHURST ST
GARDEN GROVE CA
92843-4658
US
IV. Provider business mailing address
14170 BROOKHURST ST
GARDEN GROVE CA
92843-4658
US
V. Phone/Fax
- Phone: 714-272-5081
- Fax:
- Phone: 714-272-5081
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DDS113143 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DDS113143 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: