Active NPI
Jina Lee, D.D.S.
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1134322720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 55179
- Practice address
- 2604 S Vermont Ave
Suite F
Los Angeles, CA 90007-2298 - Phone
- (323) 731-3333
- Fax
- (323) 731-7626
- NPI assigned
- Jun 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 55179 | CA | Primary |
Addresses
Primary practice location
2604 S Vermont Ave
Suite F
Los Angeles, CA 90007-2298
Mailing address
11640 Woodbridge St
#306
Studio City, CA 91604-2761
Phone (213) 458-9192
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
| License | State | Type | Specialty |
|---|---|---|---|
| 55179 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cohen Sedgh, Manavi & Pakravan Dental Corporation | Past | Accepting new patients | |
| Farid Pakravan, D.D.S., Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Los Angeles, CA
- NPI 1164767489
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1346464898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1134322720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11640 WOODBRIDGE ST",
"address_2": "#306",
"city": "STUDIO CITY",
"state": "CA",
"postal_code": "916042761",
"telephone_number": "213-458-9192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2604 S VERMONT AVE",
"address_2": "SUITE F",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900072298",
"telephone_number": "323-731-3333",
"fax_number": "323-731-7626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JINA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "55179",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.