Individual provider Active NPI

Don Le Nguyendac

  • Dentist
  • Fort Sam Houston, TX
National Provider Identifier
1033778212
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36128 Issued in TX
Practice address
3145 Garden Ave Ste 1278
Fort Sam Houston, TX 78234-7719
Phone
(210) 808-3735
Fax
(210) 808-3802
NPI assigned
Jun 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36128 TX Primary

Addresses

Primary practice location

3145 Garden Ave Ste 1278
Fort Sam Houston, TX 78234-7719

Mailing address

3145 Garden Ave Ste 1278
Fort Sam Houston, TX 78234-7719
Phone (210) 808-3735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200915002515 TX Order and Referring Only - DentistPractitioner - Dentist 9032537501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36128TXMDSocial Worker
RES.004093OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1033778212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 GARDEN AVE STE 1278",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347719",
            "telephone_number": "210-808-3735",
            "fax_number": "210-808-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 GARDEN AVE STE 1278",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347719",
            "telephone_number": "210-808-3735",
            "fax_number": "210-808-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYENDAC",
        "first_name": "DON",
        "middle_name": "LE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.