Provider Demographics
NPI:1053432617
Name:LE, HAO ANH (DDS)
Entity type:Individual
Prefix:DR
First Name:HAO
Middle Name:ANH
Last Name:LE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9690 PUFFIN AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5847
Mailing Address - Country:US
Mailing Address - Phone:480-206-4358
Mailing Address - Fax:
Practice Address - Street 1:14341 BEACH BLVD STE I
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4561
Practice Address - Country:US
Practice Address - Phone:623-845-7400
Practice Address - Fax:623-245-4159
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5552OtherDENTIST