Active NPI
Joonwoo Bae, DMD
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1386769412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS111479
- Practice address
- 2528 W Olympic Blvd
Los Angeles, CA 90006-2922 - Phone
- (213) 387-2100
- NPI assigned
- Mar 20, 2007
- Last updated
- Sep 10, 2025
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS111479 | CA | Primary |
Addresses
Primary practice location
2528 W Olympic Blvd
Los Angeles, CA 90006-2922
Mailing address
2528 W Olympic Blvd
Los Angeles, CA 90006-2922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS111479 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mesa Smiles Dentistry | Dentist | Past | Accepting new patients |
| V2M Dental Care | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757462400000",
"number": "1386769412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2528 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900062922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2528 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900062922",
"telephone_number": "213-387-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAE",
"first_name": "JOONWOO",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2025-09-10",
"certification_date": "2025-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS111479",
"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 Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.