Individual provider Active NPI

Julia Lee, DDS

  • Dentist
  • Inglewood, CA
National Provider Identifier
1588078661
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS105416 Issued in CA
Practice address
10715 S Prairie Ave
Inglewood, CA 90303-2113
Phone
(310) 419-6463
NPI assigned
Jun 17, 2014
Last updated
Sep 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS105416 CA Primary
General Practice Dentistry 1223G0001X 0401415854 VA
General Practice Dentistry 1223G0001X DS040863 PA
General Practice Dentistry 1223G0001X DEN1001777 DC
General Practice Dentistry 1223G0001X 057329 NY

Addresses

Primary practice location

10715 S Prairie Ave
Inglewood, CA 90303-2113

Mailing address

10715 S Prairie Ave
Inglewood, CA 90303-2113
Phone (310) 419-6463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160817002935 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9638464415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS105416CAMDDentist
DEN1001777DCMDGeneral Practice Dentistry
057329NYMDGeneral Practice Dentistry
DS040863PAMDGeneral Practice Dentistry
0401415854VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sue Eunsoo Ko, DDS, Inc. General Practice CurrentSince Sep 20, 2020 Accepting new patients
Julia Y Lee DDS Corp Dentist Current Accepting new patients
Scott an, DDS,Inc. PastSince Sep 20, 2020 Accepting new patients

Organizations & group practices 3

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1588078661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10715 S PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903032113",
            "telephone_number": "310-419-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10715 S PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903032113",
            "telephone_number": "310-419-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS105416",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415854",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040863",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001777",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.