Provider Demographics
NPI:1902474083
Name:LE, NHI Y (DMD)
Entity Type:Individual
Prefix:
First Name:NHI
Middle Name:Y
Last Name:LE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 BIG RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-2655
Mailing Address - Country:US
Mailing Address - Phone:228-424-4204
Mailing Address - Fax:
Practice Address - Street 1:2574 MARCIA CT
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2341
Practice Address - Country:US
Practice Address - Phone:228-388-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4211-21122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist