Individual provider Active NPI

Diem Trang Le Tu, DMD

  • Dentist
  • Clearwater, FL
National Provider Identifier
1417096173
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN14956 Issued in FL
Practice address
2194 Drew St
Clearwater, FL 33765-3214
Phone
(727) 462-5555
Fax
(727) 446-8382
NPI assigned
Feb 6, 2007
Last updated
Aug 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN14956 FL Primary

Addresses

Primary practice location

2194 Drew St
Clearwater, FL 33765-3214

Mailing address

2189 Cleveland St Ste 252
Clearwater, FL 33765-3243
Phone (727) 461-9149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160307002240 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9537465273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
FL Dental Centers PLLC Dentist PastSince Sep 11, 2022 Accepting new patients
Florida Dental Centers Past Accepting new patients

Organizations & group practices 2

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1417096173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2189 CLEVELAND ST STE 252",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653243",
            "telephone_number": "727-461-9149",
            "fax_number": "727-446-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2194 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653214",
            "telephone_number": "727-462-5555",
            "fax_number": "727-446-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TU",
        "first_name": "DIEM TRANG",
        "middle_name": "LE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN14956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.