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General NPI Number Information
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NPI Number | 1548952872
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Entity Type | Individual
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Provider Name | JONATHAN AN LE DMD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1860 TEXAS AVE
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City | BRIDGE CITY
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State | TX
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Zip | 77611-2808
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Country | US
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Telephone | 409-331-6281
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Fax |
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Provider Business Mailing Address
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Address Line | 3 NOBLE RUN
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City | HUMBLE
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State | TX
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Zip | 77346-1662
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Country | US
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Telephone | 713-992-3042
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 41907
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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