Jin Kuk Lee DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JIN KUK LEE DDS INC

Doing business as

Vivid Dental

Practice address

2440 N Josey LN Ste 103
Carrollton, TX 75006-1697

Phone

(972) 427-2875

Fax

(214) 764-0165

NPI assigned

Mar 1, 2019

Organization subpart

No

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

Authorized official

Name

Jin Kuk Lee

Title

Dentist

Phone

(310) 968-6125

Specialties & licenses 1

Addresses

Other names 1

• Vivid Dental Doing business as

Locations

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1114485745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11445 EMERALD ST STE 112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752297315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 N JOSEY LN STE 103",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750061697",
            "telephone_number": "972-427-2875",
            "fax_number": "214-764-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIN KUK LEE DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JIN KUK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "310-968-6125"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vivid Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeevan Home Health Care Inc
• Alexis Nicole Jenkins, PTA
• Leslie D Jennings, MD
• Harper Yunyeong Jeong, BCBA
• Jerry T Holubec DO, PA
• Neha Asif Jiwani
• JNJ Clinical Diagnostics LLC
• John M. Joseph, M.D., P.a.
• Suji Ann John, CPNP
• Cathryn D Johnson-Allen, LPT

• General Practice Dentistry in Carrollton, TX
• Providers in Carrollton, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.