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NPI Code Detail

MEDICARE: DR. JENNY LE DO

MEDICARE: DR. JENNY LE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2025039491MO

General Provider Information

NPI Number : 1184364945
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNY LE DO
Provider Business Mailing Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-268-4070
Fax Number : 314-268-4019
Provider Business Practice Location Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-268-4070
Fax Number : 314-268-4019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2022
Last Update Date : 12/23/2025

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