M.K.Le Professional Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

47633 Issued in CA

Legal business name

M.K.LE PROFESSIONAL DENTAL CORPORATION

Practice address

570 Masonic Way
Belmont, CA 94002-2703

Phone

(650) 517-3328

Fax

(408) 928-5673

NPI assigned

Apr 8, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mai Kim Le, DDS

Title

President

Phone

(408) 849-7649

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365379200000",
    "number": "1700229952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 MASONIC WAY",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940022703",
            "telephone_number": "650-517-3328",
            "fax_number": "408-928-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 MASONIC WAY",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940022703",
            "telephone_number": "650-517-3328",
            "fax_number": "408-928-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.K.LE PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-08",
        "last_updated": "2013-04-08",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "MAI",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-849-7649",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "47633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Momoko Lippey, DO
• Toris Keith Louie
• Paul Hamilton Lucich, LMFT
• Lulu's Dental Inc (Ralston Pediatric Dentistry)
• Julie C Lung, L.AC.
• Vanessa F Maass
• Lynda Ann Mackin, NP
• Dianne Madison
• Nalini Odom Madison, LPT
• Martin Mansmann, MA, M.F.T.

• Dentist in Belmont, CA
• Providers in Belmont, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.

Verify at the official NPI Registry.