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General NPI Number Information
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NPI Number | 1427146729
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Entity Type | Individual
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Provider Name | YEN VAN LE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 4330 EVERGREEN LANE SUITE F-1
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-941-2763
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Fax | 703-941-5846
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Provider Business Mailing Address
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Address Line | 4330 EVERGREEN LANE SUITE F-1
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-941-2763
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Fax | 703-941-5846
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401410716
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License Number State | VA
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