MEDICARE: VIET LE, DDS APC

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

General Provider Information

NPI Number	:	1659089670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIET LE, DDS APC

Provider Business Mailing Address
First Line	:	5102 STREAMVIEW DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-3202
Country	:	US
Telephone Number	:	619-717-7448
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 CAMINO DEL RIO N STE 108
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1542
Country	:	US
Telephone Number	:	619-220-8545
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VIET QUOC LE
Credential	:	DDS
Telephone Number	:	619-717-7448

Provider Enumeration Date	:	11/08/2022
Last Update Date	:	11/08/2022

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