Individual provider Active NPI

Byung Wook Lee, D.D.S.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1093878308
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41105 Issued in CA
Practice address
555 S Western Ave Ste 101
Los Angeles, CA 90020-4262
Phone
(323) 766-0667
Fax
(323) 676-7488
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 41105 CA Primary

Addresses

Primary practice location

555 S Western Ave Ste 101
Los Angeles, CA 90020-4262

Mailing address

555 S Western Ave Ste 208
Los Angeles, CA 90020-4270
Phone (323) 766-0667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
41105CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Byung Wook Lee D.D.S. Inc General Practice CurrentSince Aug 4, 2024 Accepting new patients

Locations

555 S Western Ave
Ste 208
Los Angeles, CA 90020
Phone (213) 365-2363

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1093878308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S WESTERN AVE STE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204270",
            "telephone_number": "323-766-0667",
            "fax_number": "323-676-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S WESTERN AVE STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204262",
            "telephone_number": "323-766-0667",
            "fax_number": "323-676-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BYUNG",
        "middle_name": "WOOK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41105",
            "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 Aug 3, 2024; 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.