Kelly Nguyen Le, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

61250996 Issued in WA

Practice address

3101 184TH St SW Ste 101
Lynnwood, WA 98037-4851

Phone

(425) 341-1653

NPI assigned

Jan 31, 2022

Reactivated

Jun 27, 2022

Last updated

Jun 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dr Rodney Alles Professional Services PLLC

  dba Ideal Dental - Lynnwood

  • Dentist
  • Lynnwood, WA
  • NPI 1922770585
  NPD

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1821741851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 EL CENTRO RD APT 938",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958342670",
            "telephone_number": "503-887-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 184TH ST SW STE 101",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374851",
            "telephone_number": "425-341-1653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 Arnold Ave # 88",
            "address_purpose": "LOCATION",
            "city": "McClellan",
            "state": "CA",
            "postal_code": "956521018",
            "country_code": "US",
            "telephone_number": "916-333-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "KELLY",
        "middle_name": "NGUYEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "deactivation_date": "2022-05-25",
        "reactivation_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "61250996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Maughan Law, RN
• Jonah Emmanuel Lazar, DC
• Le Muse PLLC
• Christine H Le, O.D.
• Karisa Le, PHARMD.
• Stephanie Nga Le, RPH
• Tuan Le
• Learning Inner Wisdom PLLC
• Penny Maree Lease, LMP
• Luis E Eduardo Ledesma Colchado

• Dentist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.