Individual provider Active NPI

Bill Baoquang Le, D.M.D.

  • General Practice Dentistry
  • Buena Park, CA
National Provider Identifier
1821112285
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36957 Issued in CA
Practice address
10102 Valley View St
Buena Park, CA 90620-4344
Phone
(714) 229-4898
Fax
(714) 229-4899
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 36957 CA Primary

Addresses

Primary practice location

10102 Valley View St
Buena Park, CA 90620-4344

Mailing address

10102 Valley View St
Buena Park, CA 90620-4344
Phone (714) 229-4898

Other names 1

  • Mr. Bao Quang Le Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20150805006503 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305150319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36957CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821112285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10102 VALLEY VIEW ST",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204344",
            "telephone_number": "714-229-4898",
            "fax_number": "714-229-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 VALLEY VIEW ST",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204344",
            "telephone_number": "714-229-4898",
            "fax_number": "714-229-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "BILL",
        "middle_name": "BAOQUANG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BAO",
            "last_name": "LE",
            "middle_name": "QUANG",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buena Park, CA

Sources for this page

Verify at the official NPI Registry.