Individual provider Active NPI

Alexander Hyunjoo Lee, D.D.S.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1992115034
Registry record updated May 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
63375 Issued in CA
Practice address
722 S Oxford Ave Apt 205
Los Angeles, CA 90005-2998
Phone
(707) 328-8256
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 63375 CA Primary

Addresses

Primary practice location

722 S Oxford Ave Apt 205
Los Angeles, CA 90005-2998

Mailing address

722 S Oxford Ave Apt 205
Los Angeles, CA 90005-2998
Phone (707) 328-8256

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160627002333 CA Order and Referring Only - DentistPractitioner - Dentist 7416248141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399766400000",
    "number": "1992115034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 S OXFORD AVE APT 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052998",
            "telephone_number": "707-328-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 S OXFORD AVE APT 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052998",
            "telephone_number": "707-328-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ALEXANDER",
        "middle_name": "HYUNJOO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.