Dae Won Lee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53618 Issued in CA

Practice address

12190 Perris Blvd Ste D
Moreno Valley, CA 92557-7422

Phone

(951) 486-0550

Fax

(951) 486-0566

NPI assigned

Apr 26, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Jin Kim Dental Corporation

  • Dentist
  • Moreno Valley, CA
  • NPI 1972913655
  NPD (past)
• Yahya Jaber Dental Corp

  • Dental Clinic/Center
  • Moreno Valley, CA
  • NPI 1629213657
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1750501540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 SUNFLOWER ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734211",
            "telephone_number": "909-312-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12190 PERRIS BLVD STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577422",
            "telephone_number": "951-486-0550",
            "fax_number": "951-486-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAE",
        "middle_name": "WON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mireya Matilde Ledesma
• Lee & Paik, DDS., Inc
• Ashleigh Lee
• Bog Ryul Lee, L.A.C
• Chelsea Lee
• David Chang Sheng Lee, PHARMD
• Eshban Kyunghyun Lee
• Eun Hae Lee, PHARM. D.
• Francisco Elias Lee, DO
• Hannah Lee

• General Practice Dentistry in Moreno Valley, CA
• Providers in Moreno Valley, 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 Apr 11, 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.