Jae Won Lee DDS, Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JAE WON LEE DDS, INC

Practice address

66450 Pierson Blvd
Desert Hot Springs, CA 92240-3672

Phone

(907) 346-0130

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Jae Won Lee, DDSNPI 1699289645

Title

Dentist

Phone

(907) 346-0130

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jae Won Lee

  • General Practice Dentistry
  • Desert Hot Springs, CA
  • NPI 1699289645
  NPD Authorized official

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680393600000",
    "number": "1265148605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11072 WILSON CV",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923546512",
            "telephone_number": "907-346-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66450 PIERSON BLVD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403672",
            "telephone_number": "907-346-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE WON LEE DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-04-02",
        "certification_date": "2023-04-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAE WON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "907-346-0130",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Huynh
• Intrepid Interpreters (prolegal transltors)
• Dylan Marie Izadseta, A.A, CADC II
• Kambiz Izadseta
• Melissa Eileen Jackson, LPT
• Edith Jaimes
• Bruce David Janzen
• Cassandra Patricia Jenikovsky
• Linda C Jessie
• Alina Jimenez

• Dental Clinic/Center in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2023; 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.