Sang Eun Lee, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

55451 Issued in CA

Practice address

2600 Highland Ave
Suite B
Highland, CA 92346-2179

Phone

(909) 851-7323

NPI assigned

Jan 11, 2008

Last updated

May 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Sang Eun Lee Former name

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

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.

• Sang Eun Lee D.D.S. Inc.

  • General Practice Dentistry
  • Redlands, CA
  • NPI 1083890917
  Medicare reassignment NPD Authorized official
• Sang Eun Lee Dental Corp

  dba Wellness Dental Care

  • General Practice Dentistry
  • Twentynine Palms, CA
  • NPI 1659829141
  Authorized official Same address or phone
• Sangeun Lee Dental Practice

  • Dental Clinic/Center
  • Colton, CA
  • NPI 1821654831
  NPD

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1689850315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 HIGHLAND AVE",
            "address_2": "SUITE B",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462179",
            "telephone_number": "909-851-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 HIGHLAND AVE",
            "address_2": "SUITE B",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462179",
            "telephone_number": "909-851-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANG",
        "middle_name": "EUN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55451",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "55451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANG",
            "last_name": "LEE",
            "middle_name": "EUN",
            "prefix": "MRS.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hiep Van Le, M.D.
• Oliver Le, MD
• Brian Lee, PHARM.D., M.S.
• Hin Wah Lee, M.D.
• Philip W Lee, M.D.
• Giancarlo Lembo, MD
• Amie Marie Lemos-Miller, PH.D.
• Michael G Leong, M.D.
• Atalie M Lim, MD, MBBS
• Lara Lipskey

• Oral and Maxillofacial Surgery (Dentist) in Highland, CA
• Providers in Highland, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.