Individual provider Active NPI

Esther Eunsun Lee, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1255527081
Registry record updated Mar 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55927 Issued in CA
Practice address
2655 W Olympic Blvd Ste 206
Los Angeles, CA 90006-2800
Phone
(213) 285-4011
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 55927 CA Primary

Addresses

Primary practice location

2655 W Olympic Blvd Ste 206
Los Angeles, CA 90006-2800

Mailing address

3003 Barrowby St
Bakersfield, CA 93311-9571
Phone (213) 210-3920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713002406 CA Order and Referring Only - DentistPractitioner - Dentist 4284926171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Esther Eunsun Lee General Practice CurrentSince May 14, 2023 Accepting new patients

Locations

7218 Pacific Blvd
Huntington Park, CA 90255
Phone (323) 582-2888

2655 W Olympic Blvd
Ste 206
Los Angeles, CA 90006
Phone (213) 285-4011

Organizations & group practices 1

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679702400000",
    "number": "1255527081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 BARROWBY ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119571",
            "telephone_number": "213-210-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 W OLYMPIC BLVD STE 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062800",
            "telephone_number": "213-285-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ESTHER",
        "middle_name": "EUNSUN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.