Healthcare Provider Details

I. General information

NPI: 1063330165
Provider Name (Legal Business Name): PURITY DENTAL, 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

937 CRENSHAW BLVD # 101
LOS ANGELES CA
90019-1938
US

IV. Provider business mailing address

937 CRENSHAW BLVD # 101
LOS ANGELES CA
90019-1938
US

V. Phone/Fax

Practice location:
  • Phone: 213-365-0200
  • Fax: 323-879-9381
Mailing address:
  • Phone: 213-365-0200
  • Fax: 323-879-9381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. JINHYUK JEFF LEE
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 213-365-0200