Individual provider Active NPI

Nathan Hien Le, D.M.D

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1033397310
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56789 Issued in CA
Practice address
4170 Fairmount Ave
San Diego, CA 92105-1610
Phone
(619) 280-3322
NPI assigned
Feb 8, 2008
Last updated
Apr 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 56789 CA Primary

Addresses

Primary practice location

4170 Fairmount Ave
San Diego, CA 92105-1610

Mailing address

9211 Shannon Ave
Garden Grove, CA 92841-2010
Phone (714) 642-8127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160415000813 CA Order and Referring Only - DentistPractitioner - Dentist 2062710692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56789CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan Hien Le, DDS. Inc General Practice Past Accepting new patients
Yen Hai Duong, DDS & Jimmy Tran, DMD, Inc PastSince Aug 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1033397310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9211 SHANNON AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928412010",
            "telephone_number": "714-642-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051610",
            "telephone_number": "619-280-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "NATHAN",
        "middle_name": "HIEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-08",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.