Active NPI
Kiho Lee, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Los Angeles, CA
National Provider Identifier
1033474770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 60785
- Practice address
- 10833 Le Conte Ave
CHS 20-140
Los Angeles, CA 90095-1668 - Phone
- (310) 825-4705
- NPI assigned
- Jul 9, 2012
- Last updated
- Jul 9, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 60785 | CA | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | WADE6014957 | WA |
Addresses
Primary practice location
10833 Le Conte Ave
CHS 20-140
Los Angeles, CA 90095-1668
Mailing address
10833 Le Conte Ave
CHS 20-140
Los Angeles, CA 90095-1668
Phone (310) 825-4705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WADE6014957 | WA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UCLA School of Dentisrty | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Interoperability endpoints
- kilee@direct.westerndental.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Los Angeles, CA
- NPI 1700069051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341792000000",
"number": "1033474770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE",
"address_2": "CHS 20-140",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951668",
"telephone_number": "310-825-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE",
"address_2": "CHS 20-140",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951668",
"telephone_number": "310-825-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KIHO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-09",
"last_updated": "2012-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "60785",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WA",
"license": "WADE6014957",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.