Individual provider Active NPI

Isaac Tuan Le, DDS

  • Dentist
  • Fort Smith, AR
National Provider Identifier
1285073635
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AR3933 Issued in AR
Practice address
520 So. 14TH Street
Fort Smith Dentistry
Fort Smith, AR 72901
Phone
(479) 782-3005
Fax
(479) 494-7490
NPI assigned
Jun 19, 2013
Last updated
Jun 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X AR3933 AR Primary

Addresses

Primary practice location

520 So. 14TH Street
Fort Smith Dentistry
Fort Smith, AR 72901

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
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
I20200618001618 AR Practitioner - Dentist 9537479522 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AR3933ARMDDentist
3933ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Le Western Dentistry, PLLC Current Accepting new patients
Le Western Dentistry, PLLC CurrentSince Mar 31, 2020 Accepting new patients

Locations

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1285073635",
    "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",
            "fax_number": "479-494-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SO. 14TH STREET",
            "address_2": "FORT SMITH DENTISTRY",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72901",
            "telephone_number": "479-782-3005",
            "fax_number": "479-494-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "ISAAC",
        "middle_name": "TUAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "AR3933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.