Active NPI
Phuong Fern Le, D.M.D.
- Endodontics
- Watsonville, CA
National Provider Identifier
1497839856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 51390
- Practice address
- 65 Neilson St
Suite 135
Watsonville, CA 95076-2491 - Phone
- (831) 768-9365
- Fax
- (831) 768-9393
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 51390 | CA | Primary |
Addresses
Primary practice location
65 Neilson St
Suite 135
Watsonville, CA 95076-2491
Mailing address
65 Neilson St
Suite 135
Watsonville, CA 95076-2491
Phone (831) 768-9365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51390 | CA | MD | Physical Therapy Assistant |
Interoperability endpoints
- https://api.platform.athenahealth.com/7346/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359417600000",
"number": "1497839856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 NEILSON ST",
"address_2": "SUITE 135",
"city": "WATSONVILLE",
"state": "CA",
"postal_code": "950762491",
"telephone_number": "831-768-9365",
"fax_number": "831-768-9393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 NEILSON ST",
"address_2": "SUITE 135",
"city": "WATSONVILLE",
"state": "CA",
"postal_code": "950762491",
"telephone_number": "831-768-9365",
"fax_number": "831-768-9393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "PHUONG",
"middle_name": "FERN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2013-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "51390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watsonville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.