DR SAMUEL LEE DENTAL CORP (NPI# 1528410123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528410123 |
| Entity Type | Organization |
| Organization Name | DR SAMUEL LEE DENTAL CORP |
| Other Organization Name | INTERNATIONAL ACADEMY OF DENTAL IMPLANT |
| Practice Address |
6727 Flanders Dr Ste 220 San Diego CA 92121-2926 |
| Mailing Address |
6727 Flanders Drive #220 San Diego CA 92121 |
| Practice Telephone | 8582299869 |
| Mailing Telephone | 8582299869 |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |
| Authorized Official Name | DR. SAMUEL S LEE (PRESIDENT) |
| Authorized Official Telephone | 7147183446 |
| Authorized Official Credential | DDS DMSC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 58462 | CA | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
51353 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| International Academy of Dental Implant | Doing Business As Name - Organization |
| Street Address |
6727 FLANDERS DR STE 220 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-2926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851418255 | Samuel Soonho Lee | Dentist | 6727 Flanders Dr Ste 220, San Diego, CA 92121-2926 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073966057 | Kennie Kwok Dmd, Inc | Dentist | 4060 4th Ave Ste 303, San Diego, CA 92103-2120 | 2016-07-14 |
| 1457749723 | Nguyen and Yang Dental Partnership | Dentist | 9855 Erma Rd Ste 110, San Diego, CA 92131-1007 | 2015-01-08 |
| 1447653746 | Mac, Maksim and Yang Dental Partnership A General Partnership | Dentist | 9912 Carmel Mountain Rd, San Diego, CA 92129-2808 | 2014-09-30 |
| 1518396621 | Shivali Gohel Garg | Dentist | 4320 Genesee Ave Ste 203, San Diego, CA 92117 | 2013-11-08 |
| 1013215987 | David Chun-te Yu | Dentist | 3141 Trinity Bay Pl, San Diego, CA 92110-5343 | 2011-03-02 |
| 1619295201 | Khanh V. Nguyen, Dds, Inc. | Dentist | 3570 4th Ave, San Diego, CA 92103-4940 | 2010-05-07 |
| 1720302375 | Evelyn Tarcila Huaman | Dentist | 9040 Friars Road Suite #535, San Diego, CA 92108 | 2010-03-24 |
| 1225200371 | Genevieve Abi-nahed | Dentist | 5210 Balboa Ave Ste A2, San Diego, CA 92117 | 2008-03-28 |
| 1396927299 | Khanh Vu Thuy Nguyen | Dentist | 3737 Moraga Ave Ste A104, San Diego, CA 92117 | 2007-12-03 |
| 1740481456 | George Crow | Dentist | 16253 Pinto Ridge Dr, San Diego, CA 92127-3425 | 2007-05-30 |
| Find all providers in SAN DIEGO | ||||
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| 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.