Keun Chan Lee DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

49928 Issued in CA

Legal business name

KEUN CHAN LEE DDS INC

Practice address

12531 Carson St
Hawaiian Gardens, CA 90716-1607

Phone

(562) 924-2448

Fax

(562) 402-7587

NPI assigned

Aug 25, 2016

Last updated

Aug 25, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

KEUN CHAN LEE DDS INCAs reported in NPPES

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

Authorized official

Name

Mrs. Lucero Duval

Title

Office Manager

Phone

(562) 924-2448

Specialties & licenses 1

Addresses

Part of

Keun Chan Lee DDS Inc

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keun Chan Lee, D.D.S.

  • General Practice Dentistry
  • Hawaiian Gardens, CA
  • NPI 1578684080
  NPD (past)

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1689120149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12531 CARSON ST",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907161607",
            "telephone_number": "562-924-2448",
            "fax_number": "562-402-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12531 CARSON ST",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907161607",
            "telephone_number": "562-924-2448",
            "fax_number": "562-402-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEUN CHAN LEE DDS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KEUN CHAN LEE DDS INC",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "DUVAL",
        "authorized_official_first_name": "LUCERO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "562-924-2448",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Hawaiian Gardens, CA
• Providers in Hawaiian Gardens, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.

Verify at the official NPI Registry.