Individual provider Active NPI

Thien V Le, D.D.S

  • General Practice Dentistry
  • Annandale, VA
National Provider Identifier
1851548044
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412206 Issued in VA
Practice address
5105C Backlick Rd
Annandale, VA 22003-6042
Phone
(703) 942-6612
Fax
(703) 942-6683
NPI assigned
Aug 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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 0401412206 VA Primary

Addresses

Primary practice location

5105C Backlick Rd
Annandale, VA 22003-6042

Mailing address

5217 Cather Rd
Springfield, VA 22151-3719
Phone (703) 347-3522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401412206VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentist of America, PC General Practice CurrentSince Jun 6, 2021 Accepting new patients
Jung S Pak DDS PC Past Accepting new patients

Locations

5105C Backlick Rd
Annandale, VA 22003
Phone (703) 813-6009

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1851548044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 CATHER RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221513719",
            "telephone_number": "703-347-3522",
            "fax_number": "703-942-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105C BACKLICK RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036042",
            "telephone_number": "703-942-6612",
            "fax_number": "703-942-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "THIEN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.