Bounghoon Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

AZ009869 Issued in AZ

Practice address

5220 N Dysart Rd Ste 108
Litchfield Park, AZ 85340-3046

Phone

(623) 547-0011

NPI assigned

Jul 8, 2014

Last updated

Feb 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1215343512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7439 E CONQUISTADORES DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555069",
            "telephone_number": "734-778-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 N DYSART RD STE 108",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403046",
            "telephone_number": "623-547-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BOUNGHOON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024403",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021330",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "AZ009869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Jorell Larracas
• Aaron William Latowsky, MD
• Kayla Lavender, RBT
• Kristen Ashley Lazarini, MPAS, PA-C
• Jeannie Leconte
• Nicole Lee, RBT
• Scott Allen Lee, D.D.S.
• Sul Ki Lee
• Sabrina Leon, RBT
• Ciara Leonard, RN

• Dentist in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.