NPI Code Detail JSON Logo

1194049072 NPI number — DAVID DOO-SANG LEE D.D.S.

NPI Number: 1194049072
Health Care Provider/Practitioner: DAVID DOO-SANG LEE D.D.S.

Information about “1194049072” NPI (DAVID DOO-SANG LEE D.D.S.) exists in 1194049072 in HTML format HTML  |  1194049072 in plain Text format TXT  |  1194049072 in PDF (Portable Document Format) PDF  |  1194049072 in an XML format XML  formats.

NPI Number : 1194049072 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194049072",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEE",
    "FirstName": "DAVID",
    "MiddleName": "DOO-SANG",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.D.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9953 W TARON DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ELK GROVE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95757-8160",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-640-4317",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1745 W KETTLEMAN LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LODI",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95242-9287",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-640-4317",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/20/2010",
    "LastUpdateDate": "12/13/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "054819",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "010241",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "DDS101014",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.