Individual provider Active NPI

David Lee, DMD

  • Pediatric Dentistry
  • Fullerton, CA
National Provider Identifier
1477017432
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
XXXXXXXXXXXXXXXXX Issued in CA
Practice address
100 E Valencia Mesa Dr Ste 102
Fullerton, CA 92835-3816
Phone
(714) 992-5437
NPI assigned
Jan 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X XXXXXXXXXXXXXXXXX CA Primary

Addresses

Primary practice location

100 E Valencia Mesa Dr Ste 102
Fullerton, CA 92835-3816

Mailing address

2549 Tilden Ave
Los Angeles, CA 90064-3133
Phone (310) 869-6047

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

LicenseStateTypeSpecialty
XXXXXXXXXXXXXXXXXCAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
David Lee, DMD Inc. Pediatric Dentistry CurrentSince Mar 6, 2022 Accepting new patients
Hong and Lee Dental Corporation Pediatric Dentistry PastSince Apr 6, 2025 Accepting new patients
Yun Song D.D.S Professional Dental Corporation Pediatric Dentistry PastSince Mar 1, 2022 Accepting new patients
Hong and Lee Dental Corporation Pediatric Dentistry PastSince Apr 6, 2025 Accepting new patients

Locations

18 Endeavor
Ste 302
Irvine, CA 92618
Phone (949) 653-8469

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1477017432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2549 TILDEN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643133",
            "telephone_number": "310-869-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR STE 102",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353816",
            "telephone_number": "714-992-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "XXXXXXXXXXXXXXXXX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.