Organization
VA SOUTHERN DENTAL PPO PC
Active
Parent organization
VA SOUTHERN DENTAL PPO PC
Other names
Yen Le DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
VA SOUTHERN DENTAL PPO PC
Authorized official
ERIKA MELISSA MENJIVAR (SR. CREDENTIALING SPECIALIST)
(469) 596-6137
Entity
Organization
Contact information
Practice address
4330 EVERGREEN LN STE F1, ANNANDALE, VA 22003-3258
(703) 941-2763
Mailing address
5830 GRANITE PKWY STE 780, PLANO, TX 75024-6775
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/11/2026
Last updated
02/11/2026
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