Dental Express LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12010693A Issued in AZ

Legal business name

DENTAL EXPRESS LLC

Practice address

1010 E University Dr
Building 2
Mesa, AZ 85203-8055

Phone

(317) 682-8247

NPI assigned

Oct 26, 2015

Last updated

Oct 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jungwoo Lee, DDS

Title

President

Phone

(317) 682-8247

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1043682412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E UNIVERSITY DR",
            "address_2": "BUILDING 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038055",
            "telephone_number": "317-682-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E UNIVERSITY DR",
            "address_2": "BUILDING 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038055",
            "telephone_number": "317-682-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL EXPRESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JUNGWOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-682-8247",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "12010693A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.