Gundong Lee DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GUNDONG LEE DDS, INC

Doing business as

Real Dentistry

Practice address

1235 N Harbor Blvd Ste 100
Fullerton, CA 92832-1323

Phone

(714) 525-2888

Fax

(714) 525-2123

NPI assigned

Feb 8, 2019

Last updated

Apr 6, 2021By 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

Gundong Lee, DDSNPI 1366812026

Title

Ceo

Phone

(909) 800-1994

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• REAL DENTISTRY Doing business as

Practitioners 1

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.

• Gundong Lee

  • General Practice Dentistry
  • Ontario, CA
  • NPI 1366812026
  NPD Authorized official

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1164987673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 N HARBOR BLVD STE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321323",
            "telephone_number": "714-525-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 N HARBOR BLVD STE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321323",
            "telephone_number": "714-525-2888",
            "fax_number": "714-525-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDONG LEE DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-08",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GUNDONG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-800-1994",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366812026",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REAL DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REAL DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Leah Digman Guia
• James Louie Guidangen III
• Marcus A Guillen
• Monica Flora Alferos Guillermo
• Evelyn Kay James Guillet
• Gordon Colin Gunn, MD
• Brian Michael Gunzelman, PT, DPT
• Tony Zhihao Guo
• Manmohan Gursahani, MD
• Dwane Savio Raj Gurung, M.A.

• General Practice Dentistry in Fullerton, CA
• Providers in Fullerton, 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 Apr 6, 2021; 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.