LEE PROFESSIONAL DENTAL CORP (NPI# 1033635156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033635156 |
| Entity Type | Organization |
| Organization Name | LEE PROFESSIONAL DENTAL CORP |
| Practice Address |
10921 Wilshire Blvd Ste 812 Los Angeles CA 90024-4003 |
| Practice Telephone | (310) 208-7727 |
| Practice Fax Number | 3102088866 |
| Mailing Telephone | 3102087727 |
| Mailing Fax Number | 3102088866 |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2017-08-21 |
| Authorized Official Name | THOMAS LEE (OWNER) |
| Authorized Official Telephone | 3102087727 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
39976 | CA | Dental Providers |
| Street Address |
10921 WILSHIRE BLVD STE 812 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90024-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649768615 | Nicole Sarah Tasooji | Dentist | 10921 Wilshire Blvd Ste 812, Los Angeles, CA 90024-4003 | 2018-04-25 |
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|---|---|---|---|---|
| 1710523071 | World of Health Therapy Inc | Behavioral Analyst | 1539 Woodruff Avenue, Apartment 304, Los Angeles, CA 90024 | 2019-11-21 |
| 1063988335 | Formation Inc | Nursing Care | 1611 Westwood Blvd, Los Angeles, CA 90024 | 2018-10-15 |
| 1124504956 | Sherry Sinsay Alamdari | Marriage & Family Therapist | 1328 Westwood Blvd #35, Los Angeles, CA 90024 | 2018-07-15 |
| 1386140739 | Ellen Frances Charles | Student in an Organized Health Care Education/Training Program | Ucla Psychiatry House Staff Office, 760 Westwood Plaza, Suite 37-384, Los Angeles, CA 90024 | 2018-04-04 |
| 1538663513 | John Horton | Specialist | 760 Westwood Plaza, Resident Office, Los Angeles, CA 90024 | 2018-03-22 |
| 1467979658 | Jessica Lessing O'leary | Student in an Organized Health Care Education/Training Program | 760 Westwood Plz # A7-361, Los Angeles, CA 90024 | 2017-08-28 |
| 1144745076 | Mastane M Shalikar | Dental Hygienist | 10683 Holman Ave, #5, Los Angeles, CA 90024 | 2017-08-11 |
| 1902321367 | Mamdouh Alrata | Dentist | 606 Levering Ave, Apt # 312, Los Angeles, CA 90024 | 2017-08-07 |
| 1366988834 | Sibel Kantarci | Medical Genetics | 1010 Veteran Avenue, West Medical Building, Ucla Clinical and Molecular Cytogenetics Laboratory, Los Angeles, CA 90024 | 2017-01-09 |
| 1679016976 | Iris Finger | Psychologist | 150 Medical Plaza, Suite 4238b, Los Angeles, CA 90024 | 2016-11-18 |
| Find all providers in zip 90024 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902272 | Prajna Banan | Dentist | 10833 Le Conte Ave Rm A0-156a, Los Angeles, CA 90095-3075 | 2020-11-03 |
| 1144749508 | Jenna Benko | Dentist | 1849 Greenfield Ave Apt 201, Los Angeles, CA 90025 | 2017-09-15 |
| 1841744638 | Cheryl Jonghee Park | Dentist | 925 W. 34th Street, Room 4363, Los Angeles, CA 90089 | 2016-08-09 |
| 1235593351 | Eugenio Aquino | Dentist | 814 S Harvard Blvd, Apt 12, Los Angeles, CA 90005 | 2016-04-06 |
| 1710242847 | Stacy L Yu | Dentist | 1435 S Bundy Dr, Apt 5, Los Angeles, CA 90025-2131 | 2012-07-04 |
| 1477825677 | Sil Park | Dentist | 10833 Le Conte Ave Rm A0-156b, Uc Regents Maxillofacial Prosthetics, Los Angeles, CA 90095-1668 | 2012-02-02 |
| 1194013599 | Injoon Bernard Yoo | Dentist | 3600 Wilshire Blvd. Suite 220, Los Angeles, CA 90010 | 2011-07-19 |
| 1134411523 | Michelle Ikoma | Dentist | 925 W 34th St Ste 255, Los Angeles, CA 90089-0641 | 2011-05-04 |
| 1477875458 | Ryan Christopher Wallace | Dentist | 420 E 3rd St Ste 1008, Los Angeles, CA 90013-1648 | 2010-02-18 |
| 1467696278 | Jay Kenneth Huffaker | Dentist | 402 N Larchmont Blvd, Los Angeles, CA 90004-3014 | 2009-04-23 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90024 |
Please comment or provide details below to improve the information on LEE PROFESSIONAL DENTAL CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.