| Aei Enterprise LLC | |
|
12359 Sunrise Valley Dr Ste 180 Reston VA 20191-3437 | |
| (703) 382-5611 | |
| Not Available |
| Full Name | Aei Enterprise LLC |
|---|---|
| Speciality | Dentist |
| Location | 12359 Sunrise Valley Dr Ste 180, Reston, Virginia |
| Authorized Official Name and Position | Kieu M Le (OWNER) |
| Authorized Official Contact | 7033825611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aei Enterprise LLC 12359 Sunrise Valley Dr Ste 180 Reston VA 20191-3437 Ph: (703) 382-5611 | Aei Enterprise LLC 12359 Sunrise Valley Dr Ste 180 Reston VA 20191-3437 Ph: (703) 382-5611 |
| NPI Number | 1720856370 |
|---|---|
| Provider Enumeration Date | 12/13/2023 |
| Last Update Date | 09/22/2025 |
| Certification Date | 09/22/2025 |
| Medicare PECOS PAC ID | 7517461072 |
|---|---|
| Medicare Enrollment ID | O20250917003981 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720856370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | () | Secondary |
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