Organization Active NPI

Le & Luu Dental Corp

  • Exclusive Provider Organization
  • Elk Grove, CA
National Provider Identifier
1508024431
Registry record updated Jul 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
48953 Issued in CA
Legal business name
LE & LUU DENTAL CORP
Practice address
9575 Laguna Springs Dr
Elk Grove, CA 95758-7961
Phone
(916) 691-1141
Fax
(916) 691-1119
NPI assigned
May 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2008

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

Authorized official

Name
Mrs. Merlie A Rosalin
Title
Office Manager
Phone
(916) 691-1141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 48953 CA Primary

Addresses

Primary practice location

9575 Laguna Springs Dr
Elk Grove, CA 95758-7961

Mailing address

9575 Laguna Springs Dr
Elk Grove, CA 95758
Phone (916) 691-1141

Other identifiers 1

IdentifierTypeStateIssuer
48953OtherCADENTAL LICENSE

National Provider Directory

National Provider Directory

Locations

9575 Laguna Springs Dr
Elk Grove, CA 95758
Phone (916) 691-1141

Practitioners & affiliated clinicians

Practitioners 1

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": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215216000000",
    "number": "1508024431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9575 LAGUNA SPRINGS DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95758",
            "telephone_number": "916-691-1141",
            "fax_number": "916-691-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9575 LAGUNA SPRINGS DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587961",
            "telephone_number": "916-691-1141",
            "fax_number": "916-691-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE & LUU DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-07-05",
        "status": "A",
        "authorized_official_last_name": "ROSALIN",
        "authorized_official_first_name": "MERLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "916-691-1141",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "48953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "48953",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2008; 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.