Provider Demographics
NPI:1851974810
Name:LE-LASSITER, CACLINH THAI
Entity type:Individual
Prefix:MRS
First Name:CACLINH
Middle Name:THAI
Last Name:LE-LASSITER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12511 CLIFF EDGE DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2063
Mailing Address - Country:US
Mailing Address - Phone:703-996-6311
Mailing Address - Fax:
Practice Address - Street 1:46175 WESTLAKE DR STE 430
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5886
Practice Address - Country:US
Practice Address - Phone:703-774-0014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014178081223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry