NPIMap

Organization Active NPI

Le Western Dentistry, PLLC

  • Point of Service
  • Fort Smith, AR
National Provider Identifier
1154867893
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
3933 Issued in AR
Legal business name
LE WESTERN DENTISTRY, PLLC
Practice address
520 S 14TH St
Fort Smith, AR 72901-4608
Phone
(479) 782-3005
NPI assigned
Jan 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Isaac Anh Le, DDS
Title
Owner
Phone
(479) 782-3005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 3933 AR Primary

Addresses

Primary practice location

520 S 14TH St
Fort Smith, AR 72901-4608

Mailing address

520 S 14TH St
Fort Smith, AR 72901-4608
Phone (479) 782-3005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200618001405 AR Part B Supplier - Clinic/Group Practice 2961824065 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Charleston, AR; Fort Smith, AR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Le Western Dentistry PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1154867893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S 14TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014608",
            "telephone_number": "479-782-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 14TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014608",
            "telephone_number": "479-782-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE WESTERN DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "ANH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-782-3005",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "AR",
            "license": "3933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.