Individual provider Active NPI

Brian T Le, D.D.S.

  • General Practice Dentistry
  • Euless, TX
National Provider Identifier
1730177619
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21298 Issued in TX
Practice address
305 W Euless Blvd Ste 100
Euless, TX 76040-3842
Phone
(817) 921-0883
Fax
(888) 600-6547
NPI assigned
Oct 13, 2005
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21298 TX Primary

Addresses

Primary practice location

305 W Euless Blvd Ste 100
Euless, TX 76040-3842

Mailing address

1114 E Seminary Dr
Fort Worth, TX 76115-2830
Phone (817) 921-0883

Other identifiers 3

IdentifierTypeStateIssuer
158687712MedicaidTX
158687716MedicaidTX
158687715MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160217001121 TX Order and Referring Only - General PracticePractitioner - General Practice 2365747045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21298TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Blossom Smile Dental, PLLC General Practice Past Accepting new patients
Crystal Dental of Fort Worth, P.C. Past Accepting new patients
Crystal Dental of Burleson General Practice Past Accepting new patients

Organizations & group practices 5

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1730177619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 E SEMINARY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761152830",
            "telephone_number": "817-921-0883",
            "fax_number": "888-600-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W EULESS BLVD STE 100",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403842",
            "telephone_number": "817-921-0883",
            "fax_number": "888-600-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "BRIAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158687712",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158687716",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158687715",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Euless, TX

Sources for this page

Verify at the official NPI Registry.