Provider Demographics
NPI:1306135538
Name:LE, CATHERINE MINH (DDS)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MINH
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 N BASCOM AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1869
Mailing Address - Country:US
Mailing Address - Phone:408-286-6315
Mailing Address - Fax:
Practice Address - Street 1:189 N BASCOM AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1869
Practice Address - Country:US
Practice Address - Phone:408-286-6315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028998122300000X
390200000X
AZD0091731223P0221X
CA1004791223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program