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General NPI Number Information
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NPI Number | 1851974810
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Entity Type | Individual
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Provider Name | MRS. CACLINH THAI LE-LASSITER
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Gender | Female
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 46175 WESTLAKE DR STE 430
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City | STERLING
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State | VA
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Zip | 20165-5886
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Country | US
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Telephone | 703-774-0014
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Fax |
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Provider Business Mailing Address
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Address Line | 12511 CLIFF EDGE DR
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City | HERNDON
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State | VA
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Zip | 20170-2063
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Country | US
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Telephone | 703-996-6311
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401417808
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License Number State | VA
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