Kwang Lee D.D.S. Inc.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KWANG LEE D.D.S. INC.

Practice address

1558 W Grand Ave
Grover Beach, CA 93433-2236

Phone

(805) 489-8904

Fax

(805) 474-5899

NPI assigned

May 7, 2015

Last updated

May 8, 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

Kwang Lee, DDS

Title

Dentist

Phone

(805) 489-8904

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1154709442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1558 W GRAND AVE",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332236",
            "telephone_number": "805-489-8904",
            "fax_number": "805-474-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1558 W GRAND AVE",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332236",
            "telephone_number": "805-489-8904",
            "fax_number": "805-474-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANG LEE D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KWANG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "805-489-8904",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXANOMY",
            "identifier": "1223G0001X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Grover Beach, CA
• Providers in Grover Beach, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.