Kiwoong Lee DDS, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

46863 Issued in CA

Legal business name

KIWOONG LEE DDS, INC.

Practice address

1521 N Broadway
Santa Ana, CA 92706-3906

Phone

(714) 972-2801

Fax

(714) 972-3107

NPI assigned

Aug 19, 2007

Last updated

Aug 19, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kiwoong Lee, D.D.S.

Title

Chief Officer

Phone

(714) 972-2801

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1187481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187481600000",
    "number": "1265625735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 N BROADWAY",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063906",
            "telephone_number": "714-972-2801",
            "fax_number": "714-972-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 N BROADWAY",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063906",
            "telephone_number": "714-972-2801",
            "fax_number": "714-972-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIWOONG LEE DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-19",
        "last_updated": "2007-08-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KIWOONG",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "714-972-2801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "46863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Santa Ana, CA
• Providers in Santa Ana, 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 Aug 19, 2007; 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.