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General NPI Number Information
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NPI Number | 1134617137
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Entity Type | Individual
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Provider Name | CALVIN NGUYEN LE DDS
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Gender | Male
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 2 JOURNEY STE 205
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3373
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Country | US
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Telephone | 949-643-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 20355 SHAKARI CIR
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City | YORBA LINDA
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State | CA
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Zip | 92887-3267
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Country | US
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Telephone | 714-455-9194
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Fax | 714-455-9194
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DDS103589
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License Number State | CA
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