Active NPI
Dakyeong Lee
- Geriatric Pharmacist
- Flower Mound, TX
National Provider Identifier
1023400595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 03438595
- Practice address
- 1325 Madison Ave
Flower Mound, TX 75028-5180 - Phone
- (516) 270-7420
- NPI assigned
- Feb 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 056364 | TX | |
| Pharmacist | 183500000X | 058419 | NY | |
| Geriatric Pharmacist | 1835G0303X | 03438595 | OH | Primary |
Addresses
Primary practice location
1325 Madison Ave
Flower Mound, TX 75028-5180
Mailing address
114 Colony LN
Syosset, NY 11791-4725
Phone (516) 270-7420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058419 | NY | MD | Pharmacist |
| 03438595 | OH | MD | Geriatric Pharmacist |
| 056364 | TX | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1023400595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 COLONY LN",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914725",
"telephone_number": "516-270-7420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 MADISON AVE",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750285180",
"telephone_number": "516-270-7420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DAKYEONG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-20",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "TX",
"license": "056364",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "058419",
"primary": false
},
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "OH",
"license": "03438595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flower Mound, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.