Healthcare Provider Details

I. General information

NPI: 1639349186
Provider Name (Legal Business Name): DUY LE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 ROTARY WAY
VALLEJO CA
94591-8475
US

IV. Provider business mailing address

6945 CALIFORNIA ST
SAN FRANCISCO CA
94121-1730
US

V. Phone/Fax

Practice location:
  • Phone: 707-557-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number56459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: