David S. Lee, DDS., Inc., Dba Modern Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48494 Issued in CA

Legal business name

DAVID S. LEE, DDS., INC., DBA MODERN DENTAL

Practice address

801 E Valley Blvd
#205
San Gabriel, CA 91776-3697

Phone

(626) 571-0251

Fax

(626) 571-0425

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David Shihyung Lee, D.D.S.NPI 1316333156

Title

Owner/Dentist

Phone

(626) 571-0251

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David S Lee, D.D.S.

  • General Practice Dentistry
  • San Gabriel, CA
  • NPI 1316333156
  NPD (past) Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417973058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E VALLEY BLVD",
            "address_2": "#205",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763697",
            "telephone_number": "626-571-0251",
            "fax_number": "626-571-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E VALLEY BLVD",
            "address_2": "#205",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763697",
            "telephone_number": "626-571-0251",
            "fax_number": "626-571-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID S. LEE, DDS., INC., DBA MODERN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SHIHYUNG",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "626-571-0251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in San Gabriel, CA
• Providers in San Gabriel, 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 22, 2020; 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.