Seong Wook Lee, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

54854 Issued in CA

Practice address

11438 Kenyon Way # 3C
Rancho Cucamonga, CA 91701-9230

Phone

(909) 945-5262

NPI assigned

Oct 13, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Cucamonga Peak Endodontics

  • Endodontics
  • Rancho Cucamonga, CA
  • NPI 1376928481
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1861582801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAKESIDE DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351509",
            "telephone_number": "714-351-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11438 KENYON WAY # 3C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917019230",
            "telephone_number": "909-945-5262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3016 W Charleston Blvd Ste 145",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021964",
            "country_code": "US",
            "telephone_number": "702-583-6856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SEONG",
        "middle_name": "WOOK",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NV",
            "license": "S7-128",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Lee, DDS
• Jung Yeol Lee, DMD
• Linda Lee, M.D.
• Rene W Lee, D.O.
• Ruth Sam En Lee
• Tabitha Lee
• Timothy Tien-Min Lee, MD
• Woo Jin Lee, L.AC, DIPL. O.M.
• Yeeun Lee
• Yeng Lee, RBT

• Dentist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.