SOONKI LEE DMD
NPI 1255688214
Dentist - General Practice in Los Angeles, CA
About Soonki Lee Dmd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOONKI LEE DMD (NPI 1255688214) is an individual general practice provider in Los Angeles, California, licensed in California (62164) and active in the NPI registry since August 2012. He has opted out of Medicare through June 23, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Soonki Lee Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 23, 2025 through June 23, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90006 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90006
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Soonki Lee's NPI number?
The NPI number for Soonki Lee is 1255688214. It was assigned to this individual provider in the NPPES registry on August 9, 2012.
Where is Soonki Lee located?
Soonki Lee practices at 3030 W Olympic Blvd Ste 216, Los Angeles, CA 90006. The listed phone number is (213) 384-1036.
What is Soonki Lee's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Soonki Lee enrolled in Medicare?
No. Soonki Lee has opted out of Medicare through June 23, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
What insurance does Soonki Lee accept?
Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list Soonki Lee as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Soonki Lee was last updated on February 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Soonki Lee, DMD · NPI 1255688214
General Practice provider in Los Angeles, California. Individual provider, active in the CMS NPPES registry since August 9, 2012.
## Identity
- **NPI:** 1255688214 (Entity type: Individual)
- **Enumerated:** August 9, 2012
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 62164 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3030 W OLYMPIC BLVD STE 216, Los Angeles, CA 90006-6507
- **Phone:** (213) 384-1036
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through June 23, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** February 5, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1255688214) · Data from the CMS NPPES public registry.