Crystal Dental of Burleson

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

21298 Issued in TX

Legal business name

CRYSTAL DENTAL OF BURLESON

Practice address

664 SW Wilshire Blvd
Burleson, TX 76028-5851

Phone

(817) 426-3331

Fax

(817) 426-3337

NPI assigned

Mar 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Brian T. Le, D.D.S.NPI 1730177619

Title

Dentist/Owner

Phone

(817) 426-3331

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian T Le, D.D.S.

  • General Practice Dentistry
  • Euless, TX
  • NPI 1730177619
  NPD (past) Authorized official

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

{
    "created_epoch": "1206230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1508037128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 HIGHWAY 157 N",
            "address_2": "SUITE 102",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638849",
            "telephone_number": "817-473-6200",
            "fax_number": "817-473-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285851",
            "telephone_number": "817-426-3331",
            "fax_number": "817-426-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL DENTAL OF BURLESON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-23",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "817-426-3331",
        "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": "TX",
            "license": "21298",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "21298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730177619",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jennifer H Crow, MD
• Diana A Crowell
• McKenna Lyn Crump, PT, DPT
• Nicole Cruz
• CSL Leaseco Inc.
• Jaleel Anjelo Leyco Cuasay
• Christi L Cullum, MS., CCC/SLP
• Clayton H Culp, DPM
• Nelda Norine Cunniff, D.O.

• Preferred Provider Organization in Burleson, TX
• Providers in Burleson, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.