Andre Myongson Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

56635 Issued in CA

Practice address

2707 W Olympic Blvd Ste 202
Los Angeles, CA 90006-2859

Phone

(213) 382-4336

Fax

(213) 382-4993

NPI assigned

Apr 8, 2009

Last updated

Feb 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Locations

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.

• Top Dental Pasadena

  • General Practice Dentistry
  • Pasadena, CA
  • NPI 1649737008
  NPD Authorized official
• Top West Tower Implant Center Inc

  • Dental Clinic/Center
  • Los Angeles, CA
  • NPI 1639749385
  NPD Authorized official
• Top West Tower Implant Center Inc

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1356808711
  Authorized official Same address or phone

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1598908469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 W OLYMPIC BLVD STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062859",
            "telephone_number": "213-382-4336",
            "fax_number": "213-382-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 W OLYMPIC BLVD STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062859",
            "telephone_number": "213-382-4336",
            "fax_number": "213-382-4993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13031 Kerry St",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928441638",
            "country_code": "US",
            "telephone_number": "714-638-4042",
            "fax_number": "714-638-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDRE",
        "middle_name": "MYONGSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-08",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Song Lee, PHARM.D.
• Allan K Lee, R.PH.
• Allen Lanceford Lee, PT, MPH
• Allison Whitney Lee
• Amanda Grace Lee
• Andrea Lee
• Andrew Lee, MD
• Andrew Lee
• Andrew Lee
• Andrew Choonkoo Lee, PHARM D

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.