Individual provider Active NPI

Thien Van Le, DMD

  • Dentist
  • Winter Springs, FL
National Provider Identifier
1689160483
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN24010 Issued in FL
Practice address
1122 E State Road 434 Ste 1020
Winter Springs, FL 32708-2723
Phone
(407) 327-9566
Fax
(407) 327-9570
NPI assigned
Jul 3, 2018
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2018023501 MO
Dentist 122300000X DN24010 FL Primary

Addresses

Primary practice location

1122 E State Road 434 Ste 1020
Winter Springs, FL 32708-2723

Mailing address

1122 E State Road 434 Ste 1020
Winter Springs, FL 32708-2723
Phone (407) 327-9566

Other practice location 1

12221 Saint Charles Rock Rd
Bridgeton, MO 63044
Phone (314) 828-1022

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

LicenseStateTypeSpecialty
DN24010FLMDDentist
2018023501MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
All in One Dentistry 1 Dentist PastSince Mar 1, 2020 Accepting new patients
Winter Springs Dental Inc PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1689160483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 E STATE ROAD 434 STE 1020",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327082723",
            "telephone_number": "407-327-9566",
            "fax_number": "407-327-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 E STATE ROAD 434 STE 1020",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327082723",
            "telephone_number": "407-327-9566",
            "fax_number": "407-327-9570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12221 Saint Charles Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "63044",
            "country_code": "US",
            "telephone_number": "314-828-1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "THIEN",
        "middle_name": "VAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018023501",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.