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NPI Code Detail

MEDICARE: LE DENTAL LLC

MEDICARE: LE DENTAL LLC
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
11223G0001XGeneral Practice Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21982788261OTHERNPI

General Provider Information

NPI Number : 1255773289
Entity Type Code : Organization
Provider Name (Legal Business Name) : LE DENTAL LLC
Provider Business Mailing Address
First Line : 4301 S NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3120
Country : US
Telephone Number : 702-456-8118
Fax Number :
Provider Business Practice Location Address
First Line : 4301 S NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3120
Country : US
Telephone Number : 702-456-8118
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : MR. TUAN LE
Credential : DMD
Telephone Number : 702-456-8118
Provider Enumeration Date : 07/18/2013
Last Update Date : 07/18/2013

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Directions to “LE DENTAL LLC ” Practice Location

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