Mathieu Le Quang, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46287 Issued in CA

Practice address

1801 Newport Blvd
Suite a
Costa Mesa, CA 92627-2701

Phone

(949) 645-6631

Fax

(949) 645-2051

NPI assigned

Apr 8, 2010

Last updated

Apr 8, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mathieu Lequang Other name

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1912223439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NEWPORT BLVD",
            "address_2": "SUITE A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272701",
            "telephone_number": "949-645-6631",
            "fax_number": "949-645-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NEWPORT BLVD",
            "address_2": "SUITE A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272701",
            "telephone_number": "949-645-6631",
            "fax_number": "949-645-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE QUANG",
        "first_name": "MATHIEU",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATHIEU",
            "last_name": "LEQUANG",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Crystal Ann Lawson, LMFT
• Jade Layton
• Adriana Lazarin
• Sergio R. Lazaro
• Isabel Lazo
• An Quoc Le
• Ashley Le
• Brandon Vinh Le
• Brian Le, BCBA
• Bryan Phu Le

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.