Individual provider Active NPI

Thanh M Le, DDS

  • Dentist
  • Garden Grove, CA
National Provider Identifier
1881780096
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52882 Issued in CA
Practice address
12872 Harbor Blvd
Garden Grove, CA 92840-5807
Phone
(714) 638-8273
Fax
(714) 699-2586
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 52882 CA Primary

Addresses

Primary practice location

12872 Harbor Blvd
Garden Grove, CA 92840-5807

Mailing address

2850 N Kingsgate Dr
Orange, CA 92867-2139
Phone (408) 506-1590

Other practice location 1

3500 S Bristol St
Suite 100
Santa Ana, CA 92704-7319
Phone (714) 957-6030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20171221001445 CA Practitioner - Oral Surgery 2062705759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thanh Minh Le DDS Inc CurrentSince Sep 27, 2017 Accepting new patients

Locations

12872 Harbor Blvd
Garden Grove, CA 92840
Phone (714) 638-8273

Organizations & group practices 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1881780096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 N KINGSGATE DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928672139",
            "telephone_number": "408-506-1590",
            "fax_number": "714-699-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12872 HARBOR BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405807",
            "telephone_number": "714-638-8273",
            "fax_number": "714-699-2586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 S Bristol St",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927047319",
            "country_code": "US",
            "telephone_number": "714-957-6030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "THANH",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.