Sang-Mok Samuel Lee, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53623 Issued in CA

Practice address

9862 Chapman Ave Ste B
Garden Grove, CA 92841-2726

Phone

(714) 537-9380

Fax

(714) 537-2593

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• JB Yim DDS,Inc

  • Dentist
  • Rowland Heights, CA
  • NPI 1568393957
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1871639948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18391 COLIMA RD STE 209",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917482730",
            "telephone_number": "626-854-2100",
            "fax_number": "626-854-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9862 CHAPMAN AVE STE B",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928412726",
            "telephone_number": "714-537-9380",
            "fax_number": "714-537-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANG-MOK",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lee
• Myung Churl Lee
• Myung Sook Lee
• Paul Choong Hwan Lee, MD
• Rachel Lee
• SE-Young Lee, M.D.
• Shelley Yoon-Mee Lee, M.D.
• Sheryn Sue Lee, OD
• Sun Joo Lee
• Suyeon Lee

• General Practice Dentistry in Garden Grove, CA
• Providers in Garden Grove, 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 Jan 23, 2024; 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.