Mynhan Thi Le, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107054 Issued in CA

Practice address

5675 Balboa Ave
San Diego, CA 92111-2705

Phone

(868) 268-0110

NPI assigned

Jul 5, 2021

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Minh Pham Dental Corporation

  dba La Jolla Village Smiles Dentistry and Implants

  • General Practice Dentistry
  • La Jolla, CA
  • NPI 1588092969
  NPD (past)

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1366013047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10804 DAKOTA RANCH RD",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920711196",
            "telephone_number": "407-227-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112705",
            "telephone_number": "868-268-0110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8657 Villa La Jolla Dr Ste 211",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920378309",
            "country_code": "US",
            "telephone_number": "858-272-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "MYNHAN",
        "middle_name": "THI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "26157",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37802",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mien Thuy Le
• Minh Van Le, MD
• Minh-Nhat Le
• Monica Thuy Trang Le, PHARMD
• Monique Le
• Nam-Phong Hung Le, ASW, MSW
• Nancy Le, MA, LMFT
• Nathalie Nhu Tam Ho Le, PA-C
• Nathan Hien Le, D.M.D
• Nelson Le

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.