NPIMap

Organization Active NPI

Ly Tuan Q. D.D.S.,Inc.

  • General Practice Dentistry
  • Santa Ana, CA
National Provider Identifier
1417035809
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41948 Issued in CA
Legal business name
LY TUAN Q. D.D.S.,INC.
Practice address
3736 S Bristol St
Santa Ana, CA 92704-7304
Phone
(714) 751-5538
Fax
(714) 751-0431
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kham Thi Diem Le, D.D.S.NPI 1487860250
Title
Owner
Phone
(714) 751-5538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 41948 CA Primary

Addresses

Primary practice location

3736 S Bristol St
Santa Ana, CA 92704-7304

Mailing address

3736 S Bristol St
Santa Ana, CA 92704-7304
Phone (714) 751-5538

National Provider Directory

National Provider Directory

Locations

3736 S Bristol St
Santa Ana, CA 92704
Phone (714) 751-5538

Practitioners & affiliated clinicians

Practitioners 3

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417035809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3736 S BRISTOL ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047304",
            "telephone_number": "714-751-5538",
            "fax_number": "714-751-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3736 S BRISTOL ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047304",
            "telephone_number": "714-751-5538",
            "fax_number": "714-751-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LY TUAN Q. D.D.S.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "KHAM",
        "authorized_official_middle_name": "THI DIEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-751-5538",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.