Yong Woong Lee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12014278A Issued in IN

Practice address

6129 US Highway 6
Portage, IN 46368-5058

Phone

(219) 600-8114

NPI assigned

Dec 21, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1033821046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6129 US HIGHWAY 6",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685058",
            "telephone_number": "219-600-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6129 US HIGHWAY 6",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685058",
            "telephone_number": "219-600-8114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3820 Central Ave # 2324",
            "address_purpose": "LOCATION",
            "city": "Lake Station",
            "state": "IN",
            "postal_code": "464052380",
            "country_code": "US",
            "telephone_number": "219-500-7127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "YONG WOONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-21",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014278A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario Lara, BA
• Tamara Latinovic
• Traci Lauder
• Megan Lawrence
• Kelly Learman
• Jed Leifson
• Deon J Lemmons, ST
• Anthony Frederick Lent, D.D.S
• Melissa K Lepper, OTR
• Shellina Letson

• General Practice Dentistry in Portage, IN
• Providers in Portage, IN by specialty
• General Practice Dentistry in Indiana

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

Verify at the official NPI Registry.