Individual provider Active NPI

John Han Lee, D.D.S

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1033252986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18012 Issued in TX
Practice address
9777 Ferguson Rd Ste 101
Dallas, TX 75228-3859
Phone
(214) 320-9444
Fax
(214) 320-9555
NPI assigned
Feb 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18012 TX Primary

Addresses

Primary practice location

9777 Ferguson Rd Ste 101
Dallas, TX 75228-3859

Mailing address

9777 Ferguson Rd Ste 101
Dallas, TX 75228-3859
Phone (214) 320-9444

Other identifiers 1

IdentifierTypeStateIssuer
B18012-1OtherPROVIDER NUMBER

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

LicenseStateTypeSpecialty
18012TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ark Dental, P.C. General Practice Past Accepting new patients
Ark Dental, P. C. General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033252986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 FERGUSON RD STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283859",
            "telephone_number": "214-320-9444",
            "fax_number": "214-320-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 FERGUSON RD STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283859",
            "telephone_number": "214-320-9444",
            "fax_number": "214-320-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "middle_name": "HAN",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "B18012-1",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.