1811021751 NPI number — PETER V. LE D.D.S. & BICH-THUY HOANG D.D.S.

Table of content: (NPI 1811021751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811021751 NPI number — PETER V. LE D.D.S. & BICH-THUY HOANG D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PETER V. LE D.D.S. & BICH-THUY HOANG D.D.S.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811021751
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3739 S PLAZA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92704-7463
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-549-0909
Provider Business Mailing Address Fax Number:
714-557-2320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3739 S PLAZA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92704-7463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-549-0909
Provider Business Practice Location Address Fax Number:
714-557-2320
Provider Enumeration Date:
03/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LE
Authorized Official First Name:
PETER
Authorized Official Middle Name:
V
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
714-549-0909

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  38316 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 38293 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)