Wonseok Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4338 Issued in AZ

Practice address

4444 W Northern Ave
Suite A3
Glendale, AZ 85301

Phone

(623) 842-1075

Fax

(623) 931-5881

NPI assigned

Mar 13, 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

Other identifiers 4

Other names 1

• Brandon W Lee Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Brandon W Lee DDS PC

  • Dentist
  • Glendale, AZ
  • NPI 1124174602
  NPD (past) Authorized official
• Tran Dental GRP. LLC

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1578808739
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841323672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W NORTHERN AVE",
            "address_2": "SUITE A3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85301",
            "telephone_number": "623-842-1075",
            "fax_number": "623-931-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W NORTHERN AVE",
            "address_2": "SUITE A3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85301",
            "telephone_number": "623-842-1075",
            "fax_number": "623-931-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WONSEOK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "4338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA DENTAL",
            "identifier": "533689",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "197388",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "135229",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DENTAL",
            "identifier": "AZ0489860",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDON",
            "last_name": "LEE",
            "middle_name": "W",
            "credential": "DDS PC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Thomas Won Hee Lee
• Thomas Yong Sheng Lee, OD
• Tina Lee, M.D.
• Tony W Lee, DO
• Wendy N Lee, DO
• John B Lees, D.O.
• Donald F. Lefevre II, D.O.
• Erica Jo Leffler, LMSW
• Jesse Lefrancois
• Legacy Dental Group

• Dentist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.