Active NPI
Mi-a Lee, DMD
- Dentist
- Gardena, CA
National Provider Identifier
1639216245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49929
- Practice address
- 15435 S Western Ave Ste 101
Gardena, CA 90249-4331 - Phone
- (310) 329-7600
- Fax
- (310) 329-7647
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 49929 | CA | Primary |
Addresses
Primary practice location
15435 S Western Ave Ste 101
Gardena, CA 90249-4331
Mailing address
121 S Hope St Apt 609
Los Angeles, CA 90012-5020
Phone (310) 329-7600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 49929 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471996800000",
"number": "1639216245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 S HOPE ST APT 609",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900125020",
"telephone_number": "310-329-7600",
"fax_number": "310-329-7647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15435 S WESTERN AVE STE 101",
"city": "GARDENA",
"state": "CA",
"postal_code": "902494331",
"telephone_number": "310-329-7600",
"fax_number": "310-329-7647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MI-A",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2016-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.