Susan Moon Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

101511 Issued in CA

Practice address

7540 Orangethorpe Ave Ste A1
Buena Park, CA 90621

Phone

(714) 576-2540

NPI assigned

Jul 6, 2017

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hye Won Moon D.D.S. Inc.

  • Dental Assistant
  • Los Angeles, CA
  • NPI 1730411703
  NPD (past)
• Shetty Dental Corporation

  • General Practice Dentistry
  • Hacienda Heights, CA
  • NPI 1720266554
  NPD (past)
• Swati Shetty Dental Corporation

  • Dentist
  • Buena Park, CA
  • NPI 1023515558
  NPD (past)

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572652800000",
    "number": "1477074813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 FAIRVIEW AVE UNIT A",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077047",
            "telephone_number": "626-419-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 ORANGETHORPE AVE STE A1",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "90621",
            "telephone_number": "714-576-2540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4026 W Olympic Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900193257",
            "country_code": "US",
            "telephone_number": "323-732-2828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17188 Colima Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Hacienda Heights",
            "state": "CA",
            "postal_code": "917456787",
            "country_code": "US",
            "telephone_number": "626-581-7878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "middle_name": "MOON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2019-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101511",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sang DO Lee, DC
• Sherlynn Ji Hyun Lee, PA-C
• Soledad O Lee, MD
• Sooji Hong Lee, D.D.S.
• Sujin Lee
• Susan Soojin Lee
• Yoon Jung Lee
• Leepae RX Inc
• Isaac D Leland
• Leonidas a. Johnson, O.D., a Professional Corporation

• Dentist in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2019; 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.

Verify at the official NPI Registry.