Healthcare Provider Details

I. General information

NPI: 1265396295
Provider Name (Legal Business Name): DEVON LE, D.D.S, INCORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 RESERVATION RD
MARINA CA
93933-3083
US

IV. Provider business mailing address

230 RESERVATION RD
MARINA CA
93933-3083
US

V. Phone/Fax

Practice location:
  • Phone: 831-900-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. DEVON LE
Title or Position: PRESIDENT
Credential: DDS
Phone: 408-334-2303