| Lee & Byeoun, DDS, Inc. | |
|
35900 Bob Hope Dr Ste 110 Rancho Mirage CA 92270-1765 | |
| (760) 770-4033 | |
| Not Available |
| Full Name | Lee & Byeoun, DDS, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 35900 Bob Hope Dr Ste 110, Rancho Mirage, California |
| Authorized Official Name and Position | Hyung Jin Lee (PRESIDENT) |
| Authorized Official Contact | 7607704033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee & Byeoun, DDS, Inc. 35900 Bob Hope Dr Ste 110 Rancho Mirage CA 92270-1765 | Lee & Byeoun, DDS, Inc. 35900 Bob Hope Dr Ste 110 Rancho Mirage CA 92270-1765 Ph: (760) 770-4033 |
| NPI Number | 1073267498 |
|---|---|
| Provider Enumeration Date | 02/04/2022 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/04/2022 |
| Medicare PECOS PAC ID | 5890181598 |
|---|---|
| Medicare Enrollment ID | O20220406000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073267498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
| Provider Name | Hyung Jin Lee |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669997763 PECOS PAC ID: 8123457884 Enrollment ID: I20200331002264 |
| Provider Name | Un Ji Byeoun |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1003709478 PECOS PAC ID: 3577041862 Enrollment ID: I20260128003796 |
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