MEDICARE: DR. GIANG HOANG LE D.D.S.

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	122300000X	Dentist	62592	CA
2	1223P0221X	Pediatric Dentistry	34824	TX

General Provider Information

NPI Number	:	1508298225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GIANG HOANG LE D.D.S.

Provider Business Mailing Address
First Line	:	26381 MIRAR VISTA DR
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92692-3940
Country	:	US
Telephone Number	:	714-642-2847
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 ARMY BOULE
Second Line	:	US ARMY DENTAL ACTIVITY FT. SAM HOUSTON
City	:	SAM HOUSTON
State	:	TX
Zip	:	78234-2686
Country	:	US
Telephone Number	:	714-642-2847
Fax Number	:

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

Provider Enumeration Date	:	08/05/2013
Last Update Date	:	02/23/2023

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