Ju Y Lee Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

61258 Issued in CA

Legal business name

JU Y LEE DENTAL CORPORATION

Practice address

1096 Irvine Blvd
Tustin, CA 92780

Phone

(714) 838-2875

Fax

(714) 838-2887

NPI assigned

May 8, 2017

Organization subpart

No

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

Authorized official

Name

Juyoung Lee, D.D.S.

Title

Dentist

Phone

(714) 838-2875

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1194251306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803527",
            "telephone_number": "714-838-2875",
            "fax_number": "714-838-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "714-838-2875",
            "fax_number": "714-838-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JU Y LEE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-08",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JUYOUNG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "714-838-2875",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "61258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Tustin, CA
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• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.