Lee Professional Dental Corp

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

39976 Issued in CA

Legal business name

LEE PROFESSIONAL DENTAL CORP

Practice address

10921 Wilshire Blvd Ste 812
Los Angeles, CA 90024-4003

Phone

(310) 208-7727

Fax

(310) 208-8866

NPI assigned

Aug 21, 2017

Organization subpart

No

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

Authorized official

Name

Thomas Lee, DDS

Title

Owner

Phone

(310) 208-7727

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Nicole Sarah Tasooji, DMD

  • Dentist
  • Los Angeles, CA
  • NPI 1649768615
  NPD
• Erin Hong Shusko, DDS

  • General Practice Dentistry
  • Scottsdale, AZ
  • NPI 1285107235
  NPD (past)

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1033635156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 812",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244003",
            "telephone_number": "310-208-7727",
            "fax_number": "310-208-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 812",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244003",
            "telephone_number": "310-208-7727",
            "fax_number": "310-208-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-208-7727",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "39976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Kealani Lynn Lee Archambeau
• Alfredo Lee Chang, MD
• Lee Chiropractic & Angel Health Center, Inc.
• Lee Orthopedic Institute
• Lee Orthopedic Institute, a Professional Medical Corporation
• Lee Yen Herbs & Acupuncture Inc.
• Sharon Lee-Gong
• Jean Lee-Mirzayan, D.D.S.
• Anita Lee-Smith
• Aaron Lee, MD

• Prosthodontics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Prosthodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.