Healthcare Provider Details

I. General information

NPI: 1225956360
Provider Name (Legal Business Name): JL SMILE STUDIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 E HARDY ST APT 420
INGLEWOOD CA
90303-2284
US

IV. Provider business mailing address

3998 E HARDY ST APT 420
INGLEWOOD CA
90303-2284
US

V. Phone/Fax

Practice location:
  • Phone: 213-598-9508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JIYOUNG LEE
Title or Position: CEO
Credential: DDS
Phone: 213-598-9508