Khang Phan Vinh Le, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN28997 Issued in FL

Practice address

1985 Eastwest Pkwy
Fleming Island, FL 32003-8017

Phone

(904) 639-6091

Fax

(904) 278-5233

NPI assigned

Jun 6, 2024

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1720829286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 TECHNOLOGY PARK STE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467122",
            "telephone_number": "407-543-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 EASTWEST PKWY",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038017",
            "telephone_number": "904-639-6091",
            "fax_number": "904-278-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "KHANG",
        "middle_name": "PHAN VINH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey Ryan Lada, RBT
• Emily Laddusaw, PTA
• Jordan Lane
• Kierra Danielle Lane
• Chris Le, PA-C
• Pauline Le, DMD
• Gabriel Christian Lear
• Vincent Yang Lee, PT, DPT
• Brigida L Lenderborg
• Allan Leonor, PHARMD

• General Practice Dentistry in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.