MEDICARE: DR. HA VY LE DMD

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
1	1223G0001X	General Practice Dentistry	38464	TX

General Provider Information

NPI Number	:	1235868852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HA VY LE DMD

Provider Business Mailing Address
First Line	:	5030 FAIRBANKS DR APT 106B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-3871
Country	:	US
Telephone Number	:	505-718-1020
Fax Number	:

Provider Business Practice Location Address
First Line	:	6910 N MESA ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4445
Country	:	US
Telephone Number	:	915-995-5014
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	06/08/2022

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