Sang Eun Lee D.D.S. Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55451 Issued in CA

Legal business name

SANG EUN LEE D.D.S. INC.

Practice address

620 Alabama St
Redlands, CA 92373-8059

Phone

(909) 851-7323

NPI assigned

Jan 10, 2008

Last updated

Nov 16, 2016By 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

Dr. Sang Eun Lee, D.D.S.NPI 1689850315

Title

C.E.O.

Phone

(909) 851-7323

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sang Eun Lee, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Highland, CA
  • NPI 1689850315

  General Practice

  Medicare reassignment NPD Authorized official
• Jongyeob Choi, DDS

  • Dentist
  • Highland, CA
  • NPI 1699553156
  NPD (past)
• Min Jung Yoon, DDS

  • General Practice Dentistry
  • Highland, CA
  • NPI 1689400277
  NPD (past)

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1083890917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 ALABAMA ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738059",
            "telephone_number": "909-851-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ALABAMA ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738059",
            "telephone_number": "909-851-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANG EUN LEE D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SANG",
        "authorized_official_middle_name": "EUN",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "909-851-7323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Louise Sanders Wellborn, MPT
• Gerald Henry Sanders, MFT
• Carol Sandoval, DDS
• Jasmine Sandoval
• Michaela Sandoval
• Miguel Sanint Palau, LMFT
• Francisco Manuel Santana, H.A.D. LICENSE
• Michelle Lorraine Santiago del Valle, SLP
• Luis Alberto S Santillan
• Santorini Enterprises, LLC. (Redlands Surgery Center)

• General Practice Dentistry in Redlands, CA
• Providers in Redlands, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.