Active NPI
Khoi Le
- Dentist
- Hollister, CA
National Provider Identifier
1194918987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 58147
- Practice address
- 889 Sunset Dr Ste a
Hollister, CA 95023-5601 - Phone
- (831) 637-9122
- Fax
- (831) 637-2612
- NPI assigned
- Aug 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58147 | CA | Primary |
Addresses
Primary practice location
889 Sunset Dr Ste a
Hollister, CA 95023-5601
Mailing address
889 Sunset Dr Ste a
Hollister, CA 95023-5601
Phone (831) 637-9122
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160523000651 | CA | Order and Referring Only - Dentist | 8628367141 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251244800000",
"number": "1194918987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "889 SUNSET DR STE A",
"city": "HOLLISTER",
"state": "CA",
"postal_code": "950235601",
"telephone_number": "831-637-9122",
"fax_number": "831-637-2612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "889 SUNSET DR STE A",
"city": "HOLLISTER",
"state": "CA",
"postal_code": "950235601",
"telephone_number": "831-637-9122",
"fax_number": "831-637-2612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "KHOI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-24",
"last_updated": "2009-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollister, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.