Ahn, Lee and Park Dental Group, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

54619 Issued in CA

Legal business name

AHN, LEE AND PARK DENTAL GROUP, INC

Doing business as

blessed Smile dentistry

Practice address

1155 S Diamond Bar Blvd Ste D
Diamond Bar, CA 91765-2235

Phone

(818) 279-1634

NPI assigned

Jul 2, 2013

Last updated

Jul 2, 2013By 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

Sooji H Lee, DDSNPI 1548463672

Title

Director

Phone

(818) 279-1634

Specialties & licenses 3

Addresses

Other names 1

• blessed Smile dentistry Doing business as

Locations

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.

• Sooji Hong Lee, D.D.S.

  • General Practice Dentistry
  • Buena Park, CA
  • NPI 1548463672
  NPD (past) Authorized official

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1265872444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 S DIAMOND BAR BLVD STE D",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652235",
            "telephone_number": "818-279-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S DIAMOND BAR BLVD STE D",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652235",
            "telephone_number": "818-279-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHN, LEE AND PARK DENTAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SOOJI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "818-279-1634",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54619",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41978",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "blessed Smile dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.