Active NPI
Wonjoo Lee, D.D.S.
- General Practice Dentistry
- Oakland, CA
National Provider Identifier
1194887364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 49923
- Practice address
- 3540 Grand Ave
Suite 100
Oakland, CA 94610-2010 - Phone
- (510) 208-3012
- Fax
- (510) 208-4524
- NPI assigned
- Dec 14, 2006
- Last updated
- Jan 8, 2014
- 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 | 49923 | CA | Primary |
Addresses
Primary practice location
3540 Grand Ave
Suite 100
Oakland, CA 94610-2010
Mailing address
3540 Grand Ave
Suite 100
Oakland, CA 94610-2010
Phone (510) 208-3012
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 |
|---|---|---|---|
| 49923 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wonjoo Lee Dental Corp. | Current | Accepting new patients | |
| Wonjoo Lee, DDS, Inc. | Past | Accepting new patients |
Locations
3540 Grand Ave
Ste 100
Oakland, CA 94610
Phone (510) 208-3012
Interoperability endpoints
- wlee@direct.westerndental.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1194887364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 GRAND AVE",
"address_2": "SUITE 100",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946102010",
"telephone_number": "510-208-3012",
"fax_number": "510-208-4524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 GRAND AVE",
"address_2": "SUITE 100",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946102010",
"telephone_number": "510-208-3012",
"fax_number": "510-208-4524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "WONJOO",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "49923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.