NPIMap

Organization Active NPI

Soonki Lee DDS PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
National Provider Identifier
1033618681
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DDS62164 Issued in CA
Legal business name
SOONKI LEE DDS PC
Practice address
3030 W Olympic Blvd Ste 216
Los Angeles, CA 90006-6507
Phone
(213) 384-1036
NPI assigned
Feb 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Authorized official

Name
Soonki Lee, DDS
Title
Owner
Phone
(213) 384-1036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DDS62164 CA Primary

Addresses

Primary practice location

3030 W Olympic Blvd Ste 216
Los Angeles, CA 90006-6507

Mailing address

3030 W Olympic Blvd Ste 216
Los Angeles, CA 90006-6507
Phone (213) 384-1036

National Provider Directory

National Provider Directory

Locations

3030 W Olympic Blvd
Ste 216
Los Angeles, CA 90006
Phone (213) 384-1036

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1033618681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W OLYMPIC BLVD STE 216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900066507",
            "telephone_number": "213-384-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W OLYMPIC BLVD STE 216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900066507",
            "telephone_number": "213-384-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOONKI LEE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-09",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SOONKI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-384-1036",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS62164",
            "primary": true
        }
    ],
    "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 Sep 13, 2018; 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.