Active NPI
Kira Lee
- Pediatric Dentistry
- Glendale, CA
National Provider Identifier
1851831416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DDS103603
- Practice address
- 1808 Verdugo Blvd Ste 312
Glendale, CA 91208-1456 - Phone
- (818) 790-6721
- NPI assigned
- Mar 2, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DDS103603 | CA | Primary |
Addresses
Primary practice location
1808 Verdugo Blvd Ste 312
Glendale, CA 91208-1456
Mailing address
5028 Princess Anne Rd
La Canada, CA 91011-2423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS103603 | CA | MD | Pediatric Dentist |
Interoperability endpoints
- kira.lee.p1@direct.wcchc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1851831416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5028 PRINCESS ANNE RD",
"city": "LA CANADA",
"state": "CA",
"postal_code": "910112423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 VERDUGO BLVD STE 312",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081456",
"telephone_number": "818-790-6721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KIRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-02",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "DDS103603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.