David Formosan Lee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50 053083 Issued in NY

Practice address

30 E 40TH St RM 305
New York, NY 10016-1247

Phone

(212) 370-1919

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Formoso Dental PC

  • Dentist
  • New York, NY
  • NPI 1629490826
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1003031402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 TIMBERLAKE DRIVE",
            "city": "LOUISVILLE",
            "state": "TN",
            "postal_code": "37777",
            "telephone_number": "865-970-2821",
            "fax_number": "865-983-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 40TH ST RM 305",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161247",
            "telephone_number": "212-370-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAVID",
        "middle_name": "FORMOSAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50 053083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02907899",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Justine Lee, MD
• Dara Lee, D.M.D.
• David Lee
• David B Lee, DPT
• David Chung Lee, MD
• David L Lee, MD
• David Sung Lee, MD
• David Y Lee
• Dawon Lee
• Dayoon Lee, DDS

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.