Active NPI
Pauline Le, DMD
- Dentist
- Fleming Island, FL
National Provider Identifier
1265955611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN22819
- Practice address
- 1845 Eastwest Pkwy Ste 3
Fleming Island, FL 32003-6405 - Phone
- (904) 278-7308
- NPI assigned
- Jul 18, 2017
- Sex
- Female
- 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 | DN22819 | FL | Primary |
Addresses
Primary practice location
1845 Eastwest Pkwy Ste 3
Fleming Island, FL 32003-6405
Mailing address
14030 Atlantic Blvd Unit 2212
Jacksonville, FL 32225-3896
Phone (904) 881-4771
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN22819 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500336000000",
"number": "1265955611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14030 ATLANTIC BLVD UNIT 2212",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322253896",
"telephone_number": "904-881-4771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1845 EASTWEST PKWY STE 3",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320036405",
"telephone_number": "904-278-7308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "PAULINE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-18",
"last_updated": "2017-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN22819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fleming Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.