{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "LEE, WEE& BAEK.DDS.INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "61325 29 PALMS HWY STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JOSHUA TREE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92252-1912",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-366-0420",
"MailingAddressFaxNumber": "760-360-0520",
"FirstLinePracticeLocationAddress": "61325 29 PALMS HWY STE A",
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"PracticeLocationAddressCityName": "JOSHUA TREE",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-366-0420",
"PracticeLocationAddressFaxNumber": "760-360-0520",
"EnumerationDate": "03/12/2008",
"LastUpdateDate": "03/12/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAEK",
"AuthorizedOfficialFirstName": "JIN NAM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SECRETARY",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S",
"AuthorizedOfficialTelephoneNumber": "951-756-0069",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "54709",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}