Khoa Dai Le, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

31942 Issued in CA

Practice address

8181 Bolsa Ave
Midway City, CA 92655-1223

Phone

(714) 698-8181

Fax

(714) 698-1609

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Khoa Dai Le DDS Inc

  • Dentist
  • Midway City, CA
  • NPI 1770766545
  NPD (past) Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1598891988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8181 BOLSA AVE",
            "city": "MIDWAY CITY",
            "state": "CA",
            "postal_code": "926551223",
            "telephone_number": "714-698-8181",
            "fax_number": "714-698-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8181 BOLSA AVE",
            "city": "MIDWAY CITY",
            "state": "CA",
            "postal_code": "926551223",
            "telephone_number": "714-698-8181",
            "fax_number": "714-698-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "KHOA",
        "middle_name": "DAI",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "31942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tan Canh Huynh, D.D.S.
• Amy Judge
• Khoa Dai Le DDS Inc
• Marco Kostandy
• Ivane Le-Nguyen, D.M.D
• Nam Quoc Le, D.O.
• Vilma Lechuga
• Lion Heart Recovery Services Oc LLC
• Minh Quang Luong, PHARMD
• Damaris Martinez Marrufo

• Dentist in Midway City, CA
• Providers in Midway City, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.