Active NPI
Beom Mo Lee Dental Corporation
- Health Maintenance Organization
- Los Angeles, CA
National Provider Identifier
1184766677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- 46284
- Legal business name
- BEOM MO LEE DENTAL CORPORATION
- Doing business as
- O Smile Dentistry
- Practice address
- 966 S Western Ave
207
Los Angeles, CA 90006 - Phone
- (323) 734-2117
- Fax
- (323) 734-2117
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Beom Mo Lee, DDS PHD
- Title
- President
- Phone
- (323) 734-3710
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | 46284 | CA | Primary |
Addresses
Primary practice location
966 S Western Ave
207
Los Angeles, CA 90006
Mailing address
966 S Western Ave
207
Los Angeles, CA 90006
Phone (323) 734-2117
Other names 1
- O Smile Dentistry
National Provider Directory
National Provider Directory- Tax ID family
- Beom Mo Lee Dental Corp
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1831395367
Locations
966 S Western Ave
Ste 207
Los Angeles, CA 90006
Phone (323) 734-2117
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Los Angeles, CA
- NPI 1235122243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216339200000",
"number": "1184766677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "966 S WESTERN AVE",
"address_2": "207",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90006",
"telephone_number": "323-734-2117",
"fax_number": "323-734-2117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "966 S WESTERN AVE",
"address_2": "207",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90006",
"telephone_number": "323-734-2117",
"fax_number": "323-734-2117"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEOM MO LEE DENTAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-13",
"last_updated": "2008-07-18",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "BEOM MO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "323-734-3710",
"authorized_official_credential": "DDS PHD"
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "CA",
"license": "46284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "O Smile Dentistry",
"code": "3",
"type": "Doing Business As"
}
]
}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 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.