Provider Demographics
NPI:1487809349
Name:WIN LE D.D.S. P.C.
Entity type:Organization
Organization Name:WIN LE D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-453-8417
Mailing Address - Street 1:3122 UNION ST
Mailing Address - Street 2:CF-1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2338
Mailing Address - Country:US
Mailing Address - Phone:347-453-8417
Mailing Address - Fax:
Practice Address - Street 1:3122 UNION ST
Practice Address - Street 2:CF-1A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2338
Practice Address - Country:US
Practice Address - Phone:347-453-8417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052616122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty