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General NPI Number Information
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NPI Number | 1083275820
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Entity Type | Individual
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Provider Name | RYAN LE DMD, MBA, MMB
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Gender | Male
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1325 N GOLDENROD RD
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City | ORLANDO
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State | FL
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Zip | 32807-8332
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Country | US
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Telephone | 407-381-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 14267 CREST PALM AVE
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City | WINDERMERE
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State | FL
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Zip | 34786-6843
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Country | US
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Telephone | 407-798-8005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11366
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN28626
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License Number State | FL
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