Individual provider Active NPI

Christine P Le, D.D.S.

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1245518471
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26529 Issued in TX
Practice address
2815 Azle Ave
Fort Worth, TX 76106-5106
Phone
(817) 624-0222
Fax
(817) 624-0221
NPI assigned
Jul 21, 2011
Last updated
Aug 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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 26529 TX Primary

Addresses

Primary practice location

2815 Azle Ave
Fort Worth, TX 76106-5106

Mailing address

2815 Azle Ave
Fort Worth, TX 76106-5106
Phone (817) 624-0222

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
I20160106002692 TX Order and Referring Only - DentistPractitioner - Dentist 5496057515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26529TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1245518471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 AZLE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761065106",
            "telephone_number": "817-624-0222",
            "fax_number": "817-624-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 AZLE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761065106",
            "telephone_number": "817-624-0222",
            "fax_number": "817-624-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "CHRISTINE",
        "middle_name": "P",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.