NPIMap

Organization Active NPI

E Dental PLLC

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1043634561
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D06195 Issued in AZ
Legal business name
E DENTAL PLLC
Practice address
5501 N 19TH Ave Ste 206
Phoenix, AZ 85015-2452
Phone
(602) 249-4465
NPI assigned
Feb 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Authorized official

Name
Dr. Ju-Young LeeNPI 1861402737
Title
Dentist
Phone
(602) 249-4465

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D06195 AZ Primary

Addresses

Primary practice location

5501 N 19TH Ave Ste 206
Phoenix, AZ 85015-2452

Mailing address

5501 N 19TH Ave Ste 206
Phoenix, AZ 85015-2452
Phone (602) 249-4465

National Provider Directory

National Provider Directory

Locations

5501 N 19th Ave
Ste 206
Phoenix, AZ 85015
Phone (602) 249-4465

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": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1043634561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 N 19TH AVE STE 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152452",
            "telephone_number": "602-249-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 N 19TH AVE STE 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152452",
            "telephone_number": "602-249-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JU-YOUNG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "602-249-4465",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D06195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.