Dr. Samuel Sung-Jae Lee, D.D.S., M.S.
Dentist, Orthodontics and Dentofacial Orthopedics in San Clemente, CA. Individual provider (NPI-1).
NPI number1447445192
StatusActive
Last updated in NPPESMar 17, 2011
Details
- NPI
- 1447445192
- Entity type
- Individual (NPI-1)
- Name
- Dr. Samuel Sung-Jae Lee
- Credential
- D.D.S., M.S.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 6, 2007
- Last updated
- Mar 17, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 56206 | CA | Yes |
Practice location
511 Calle MalaguenaSan Clemente, CA 92672-2357
Phone 949-697-4258
Mailing address
511 Calle MalaguenaSan Clemente, CA 92672-2357
Phone 949-697-4258
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All 7 Orthodontics and Dentofacial Orthopedics Dentistry providers in San Clemente · All 1,327 providers in San Clemente
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