Organization Active NPI

Kha Dang Le and Anne Hangman Le DMD Inc

  • General Practice Dentistry
  • San Bernardino, CA
National Provider Identifier
1255577086
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41453 Issued in CA
Legal business name
KHA DANG LE AND ANNE HANGMAN LE DMD INC
Practice address
2150 N Waterman Ave
Suite # 103
San Bernardino, CA 92404
Phone
(909) 882-7974
Fax
(909) 713-0160
NPI assigned
Dec 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Authorized official

Name
Dr. Kha Dang Le, DMD
Title
Owner
Phone
(909) 882-7974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 41453 CA Primary

Addresses

Primary practice location

2150 N Waterman Ave
Suite # 103
San Bernardino, CA 92404

Mailing address

2150 N Waterman Ave
Suite # 103
San Bernardino, CA 92404
Phone (909) 882-7974

Other names 1

  • Waterman Dentistry Other name

National Provider Directory

National Provider Directory

Locations

2150 N Waterman Ave
Ste 103
San Bernardino, CA 92404
Phone (909) 882-7974

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": "1230508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1255577086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "SUITE # 103",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92404",
            "telephone_number": "909-882-7974",
            "fax_number": "909-713-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "SUITE # 103",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92404",
            "telephone_number": "909-882-7974",
            "fax_number": "909-713-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHA DANG LE AND ANNE HANGMAN LE DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "KHA",
        "authorized_official_middle_name": "DANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-882-7974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterman Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.