Individual provider Active NPI

Joon-Ku Lee, D.M.D

  • General Practice Dentistry
  • Sunnyvale, CA
National Provider Identifier
1720006406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43289 Issued in CA
Practice address
990 W Fremont Ave
Suite# T
Sunnyvale, CA 94087-3021
Phone
(408) 774-2828
Fax
(408) 774-2990
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43289 CA Primary

Addresses

Primary practice location

990 W Fremont Ave
Suite# T
Sunnyvale, CA 94087-3021

Mailing address

990 W Fremont Ave
Suite# T
Sunnyvale, CA 94087-3021
Phone (408) 774-2828

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160322002783 CA Order and Referring Only - DentistPractitioner - Dentist 0143527978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: jlee249858@direct-ucsfmedicalcenter.org

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720006406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 W FREMONT AVE",
            "address_2": "SUITE# T",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873021",
            "telephone_number": "408-774-2828",
            "fax_number": "408-774-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W FREMONT AVE",
            "address_2": "SUITE# T",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873021",
            "telephone_number": "408-774-2828",
            "fax_number": "408-774-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOON-KU",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.