Loo Un Lee, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105798 Issued in CA

Practice address

19510 Van Buren Blvd Ste F5
Riverside, CA 92508-9458

Phone

(951) 653-6663

Fax

(951) 656-5638

NPI assigned

Apr 12, 2019

Last updated

Aug 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Desar and Patel Professional Dental Corporation

  dba Orangecrest Dental Group

  • Dentist
  • Riverside, CA
  • NPI 1336287622
  NPD (past)

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1396208567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19510 VAN BUREN BLVD STE F5",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089458",
            "telephone_number": "951-653-6663",
            "fax_number": "951-656-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19510 VAN BUREN BLVD STE F5",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089458",
            "telephone_number": "951-653-6663",
            "fax_number": "951-656-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "LOO UN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105798",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalesia Lee
• Kelsey Lee, PHARMD
• Kristen Masae Alfonso Lee, CMT
• Linda Lee
• Lisa Lee, MSW, ACSW
• Marissa Lee
• Omarra Lee
• Patricia Jeewon Lee, NP
• Paul Lee
• Randy Horn-Wei Lee, DO

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.