Benjamin Bao Le DMD, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BENJAMIN BAO LE DMD, INC

Practice address

1702 N Avalon Blvd
Wilmington, CA 90744-1433

Phone

(310) 835-0251

Fax

(310) 835-1690

NPI assigned

Jun 3, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Bao Le, D.M.DNPI 1336249242

Title

Owner

Phone

(310) 835-0251

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Bao Le, DMD

  • General Practice Dentistry
  • Wilmington, CA
  • NPI 1336249242

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1124694765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907441433",
            "telephone_number": "310-835-0251",
            "fax_number": "310-835-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907441433",
            "telephone_number": "310-835-0251",
            "fax_number": "310-835-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN BAO LE DMD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "BAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-835-0251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Wilmington, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.