Sam Hwan Lee, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

105867 Issued in CA

Practice address

5817 Pine Ave Ste a
Chino Hills, CA 91709-6533

Phone

(909) 606-4500

NPI assigned

Dec 21, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Seung-Hwan Lee Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1376139634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5817 PINE AVE STE A",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5817 PINE AVE STE A",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096533",
            "telephone_number": "909-606-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SAM",
        "middle_name": "HWAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-21",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "105867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEUNG-HWAN",
            "last_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Erie Lee
• Ji Seong Lee, PHARMD
• John Lee Jr., DMD
• Kaini Lee, PHARMD
• Kenneth K. Lee, D.D.S.
• Sung W Lee, D.D.S.
• Yi-Chien Emma Lee, D.O.
• Lemi Lilo Psychiatric Nursing Apc
• Let'S Talk Ministries
• Shwe Kyi Lew, DO

• Orthodontics and Dentofacial Orthopedics Dentistry in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.