Individual provider Active NPI

Quang-Jason Le

  • General Practice Dentistry
  • Mansfield, TX
National Provider Identifier
1932828944
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38971 Issued in TX
Practice address
2891 Matlock Rd Ste 101
Mansfield, TX 76063-5383
Phone
(682) 518-2350
NPI assigned
Aug 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 38971 TX Primary

Addresses

Primary practice location

2891 Matlock Rd Ste 101
Mansfield, TX 76063-5383

Mailing address

7 Meera CT
Mansfield, TX 76063-3743
Phone (817) 308-2029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20221025000323 TX Order and Referring Only - DentistPractitioner - Dentist 4385010826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38971TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of Mansfield PC PastSince Aug 28, 2022 Accepting new patients

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1932828944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MEERA CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633743",
            "telephone_number": "817-308-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 MATLOCK RD STE 101",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635383",
            "telephone_number": "682-518-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "QUANG-JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.