Ouk Hyun Lee

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS102731 Issued in CA

Practice address

11328 Bartlett Ave Ste 2
Adelanto, CA 92301-1913

Phone

(760) 237-8848

NPI assigned

Jul 30, 2018

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 and National Provider Directory roles.

• Tri-State Community Healthcare Center

  • Federally Qualified Health Center (FQHC)
  • Needles, CA
  • NPI 1922356369
  Medicare reassignment NPD
• Tri-State Community Healthcare Center

  • Federally Qualified Health Center (FQHC)
  • Laughlin, NV
  • NPI 1174125892
  NPD

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1669950069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BARTON RD APT 4116",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735371",
            "telephone_number": "253-327-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11328 BARTLETT AVE STE 2",
            "city": "ADELANTO",
            "state": "CA",
            "postal_code": "923011913",
            "telephone_number": "760-237-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "OUK HYUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS102731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalicia Jackson
• Ebony Nechole Jackson
• Joseph M Molina MD Professional Corporation Southern California
• Joseph M Molina MD Professional Corporation-Southern California
• Keana Turner
• Jessica Louisa Lester
• Life Community Development
• Qianna Liu
• Longs Drug Stores California, LLC
• Randall Kyle Lynn

• General Practice Dentistry in Adelanto, CA
• Providers in Adelanto, 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 Aug 18, 2023; 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.