Stephanie Chung Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

103033 Issued in CA

Practice address

171 Inner Loop Road
Fort Irwin, CA 92310-0000

Phone

(760) 380-3166

NPI assigned

Aug 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Stephanie Heejin Chung Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1023597333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 INNER LOOP ROAD",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923100000",
            "telephone_number": "760-380-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 INNER LOOP ROAD",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923100000",
            "telephone_number": "760-380-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "STEPHANIE",
        "middle_name": "CHUNG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "CHUNG",
            "middle_name": "HEEJIN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gregory Edward Le, DMD
• Isabel Moreno Leavitt, R.N.
• Joann Ledoux, CRNA
• Frances Marie Lee
• Joshua Hyungkyu Lee, D.D.S.
• Robert Gene Lehtonen III, CRNA
• Lamar Angelo Leseur, DA
• Steven Leung, DDS
• Alana Mahealani Liba
• Kristin Marie Lightner, RN

• Dentist in Fort Irwin, CA
• Providers in Fort Irwin, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.