Kang Yul Lee, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45130 Issued in CA

Practice address

2180 Lake Tahoe Blvd.
Ste #5
South Lake Tahoe, CA 96150

Phone

(530) 541-8229

Fax

(530) 541-8964

NPI assigned

Nov 21, 2006

Last updated

Aug 6, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hyun Myung Ha DDS. Inc.

  • Dental Clinic/Center
  • South Lake Tahoe, CA
  • NPI 1629697875
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1861567349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 LAKE TAHOE BLVD",
            "address_2": "STE #5",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "96150",
            "telephone_number": "530-541-8229",
            "fax_number": "530-541-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 LAKE TAHOE BLVD.",
            "address_2": "STE #5",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "96150",
            "telephone_number": "530-541-8229",
            "fax_number": "530-541-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KANG",
        "middle_name": "YUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45130",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4897T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G91956",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Valley Fire Protection District
• Timothy Langan, D.C.
• Catherine Lawlor, PSYD
• Nathan Andrew Lease, MD
• David Lee, PHARMD
• Selwyn Lee
• Keith R Lemay, PA-C
• Burton Lerman, M. D.
• Amelia Marie Lewis
• John Frederick Lewison, MD

• General Practice Dentistry in South Lake Tahoe, CA
• Providers in South Lake Tahoe, 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 Aug 6, 2015; 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.