1. Home
  2. Directory
  3. California
  4. Santa Rosa
  5. Dentist
  6. NPI Profile

NICOLE N LE DDS
NPI 1629059837
Dentist in Santa Rosa, CA

Active since November 07, 2005Opted out of Medicare · through Mar 31, 2028
615 NORTH STREET, SANTA ROSA, CA 95404(707) 539-3999(707) 539-3998 Get Directions Write a Review

NPPES record last updated: August 4, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nicole N Le Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE N LE DDS (NPI 1629059837) is an individual dentist in Santa Rosa, California, licensed in California (48942) and active in the NPI registry since November 2005. She has opted out of Medicare through March 31, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1629059837
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameNICOLE N LECredential: DDS
Location Address615 NORTH STREETSanta Rosa, CA 95404
Mailing Address3516 Kendell Hill DriveSanta Rosa, CA 95404 · (707) 539-3999 · Fax (707) 539-3998
Phone(707) 539-3999
Fax(707) 539-3998
Sole ProprietorNo
Enumeration DateNovember 7, 2005
Last NPPES UpdateAugust 4, 2020
NPPES CertifiedAugust 4, 2020
✔ NPI 1629059837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 48942
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
615 NORTH STREET, Santa Rosa, CA 95404
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole N Le Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 31, 2016 through March 31, 2028.

Opt-Out Effective DateMarch 31, 2016
Opt-Out In Effect ThroughMarch 31, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95404 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.16 typical visit price
range $63.04 – $187.01
Typical copayment $24.04 (range $15.76 – $46.75)
Most-billed visit code 99203
Established Patient
$77.94 typical visit price
range $21.02 – $153.40
Typical copayment $19.48 (range $5.25 – $38.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN MICHAEL SAVKO D.D.S.
Dentist (General Practice)
615 NORTH STREET
SANTA ROSA, CA 95404
Sonoma County (707) 539-3999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Le's NPI number?

The NPI number for Nicole Le is 1629059837. It was assigned to this individual provider in the NPPES registry on November 7, 2005.

Where is Nicole Le located?

Nicole Le practices at 615 North Street, Santa Rosa, CA 95404. The listed phone number is (707) 539-3999.

What is Nicole Le's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Nicole Le enrolled in Medicare?

No. Nicole Le has opted out of Medicare through March 31, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Nicole Le was last updated on August 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.