Individual provider Active NPI

Hy T Le

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Winter Haven, FL
National Provider Identifier
1417576372
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN25716 Issued in FL
Practice address
1475 6TH St NW
Winter Haven, FL 33881-2365
Phone
(973) 328-9100
NPI assigned
Apr 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN25716 FL
Student in an Organized Health Care Education/Training Program 390200000X
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN25716 FL Primary

Addresses

Primary practice location

1475 6TH St NW
Winter Haven, FL 33881-2365

Mailing address

4525 Brittany Heyworth Way Apt 205
Lakeland, FL 33813-3178
Phone (609) 742-7601

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
I20221019002809 FL Order and Referring Only - DentistPractitioner - Dentist 8426424243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN25716FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1417576372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 BRITTANY HEYWORTH WAY APT 205",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133178",
            "telephone_number": "609-742-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 6TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812365",
            "telephone_number": "973-328-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "HY",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25716",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN25716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.