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General NPI Number Information
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NPI Number | 1972655165
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Entity Type | Organization
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Legal Business Name | THIMY D. LE DMD, INC.
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 11100 WARNER AVE SUITE #160
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7506
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Country | US
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Telephone | 714-799-9945
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Fax | 657-218-9699
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Provider Business Mailing Address
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Address Line | P.O. BOX 5728
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92615
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Country | US
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Telephone | 714-799-9945
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Fax | 714-799-9505
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Authorized Official
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Title or Position | DENTIST
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Name | DR. THIMY D LE
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Credential | DMD
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Telephone | 714-799-9945
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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 | 48943
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 48943
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License Number State | CA
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