Active NPI
Jinhyuk Lee, DDS
- Endodontics
- Los Angeles, CA
National Provider Identifier
1376870816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 53620
- Practice address
- 3460 Wilshire Blvd
Suite 1007
Los Angeles, CA 90010-2206 - Phone
- (213) 365-0200
- NPI assigned
- Nov 4, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 53620 | CA | Primary |
Addresses
Primary practice location
3460 Wilshire Blvd
Suite 1007
Los Angeles, CA 90010-2206
Mailing address
3460 Wilshire Blvd
Suite 1007
Los Angeles, CA 90010-2206
Phone (213) 365-0200
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160413000764 | CA | Order and Referring Only - Other (Non-Physician) | 1052619731 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257292800000",
"number": "1376870816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3460 WILSHIRE BLVD",
"address_2": "SUITE 1007",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102206",
"telephone_number": "213-365-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3460 WILSHIRE BLVD",
"address_2": "SUITE 1007",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102206",
"telephone_number": "213-365-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JINHYUK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-04",
"last_updated": "2009-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "53620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; 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.