Youngshin Lee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS106977 Issued in CA

Practice address

1395 Kelton Ave Apt 312
Los Angeles, CA 90024-7803

Phone

(213) 215-6758

NPI assigned

Feb 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

State licenses

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1669127015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 KELTON AVE APT 312",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900247803",
            "telephone_number": "213-215-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 KELTON AVE APT 312",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900247803",
            "telephone_number": "213-215-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YOUNGSHIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS106977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMV",
            "identifier": "D8634416",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "youngshinlee@dentistry.ucla.edu",
            "affiliation": "N",
            "endpointDescription": "Secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1395 Kelton Ave Apt 312",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900247803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Young-Jik Lee, M.D.
• Younghoon Lee, PTA
• Youngjoo Lee
• Youngkeun Lee, L. AC.
• Youngnam Lee, L.AC.
• Youngyoun Lee, OT
• Yu Fon Lee, MD
• Yu-Tien Lee, DMD, MBA
• Yuji Lee, PHARM.D.
• Yujin Lee, DDS

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.