S. Kwon Lee, MD, Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C54971 Issued in CA

Legal business name

S. KWON LEE, MD, INC

Practice address

7807 Laguna Blvd Ste 480
Elk Grove, CA 95758-7953

Phone

(916) 242-8499

Fax

(916) 405-7440

NPI assigned

Jan 5, 2012

Organization subpart

No

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

Authorized official

Name

Seung Kwon Lee, M.D.

Title

President

Phone

(916) 242-8499

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Seung Kwon Lee, M.D.

  • Surgery Physician
  • Elk Grove, CA
  • NPI 1700880267
  Medicare reassignment NPD

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1851661953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 583211",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957580057",
            "telephone_number": "916-242-8499",
            "fax_number": "916-405-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7807 LAGUNA BLVD STE 480",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587953",
            "telephone_number": "916-242-8499",
            "fax_number": "916-405-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. KWON LEE, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SEUNG",
        "authorized_official_middle_name": "KWON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-242-8499",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "C54971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Russo
• Alyssa Ryan
• Yuri Rybin Jr., PTA
• S Park DDS Inc (Grove Dental Group)
• S. Jang DDS Incorporated (Smile Time Dental)
• S.Y. Jang DDS Corporatiom (Make A Smile)
• S.Y.Y Jang DDS Corp (Kids Dentist Plus)
• S.Y.Y Jang DDS Corp (Kids Dentist Plus)
• S&J Transportation
• Jill Robin Saberman, RN, MSN, WHNP-BC

• Surgery Physician in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.