Active NPI
Seokwoo Lee, DDS
- Periodontics
- Forest Hills, NY
National Provider Identifier
1073725891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 053448-1
- Practice address
- 10750 Queens Blvd
Forest Hills, NY 11375-4251 - Phone
- (718) 793-1777
- Fax
- (718) 544-5123
- NPI assigned
- May 4, 2007
- Last updated
- Nov 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 053448-1 | NY | Primary |
Addresses
Primary practice location
10750 Queens Blvd
Forest Hills, NY 11375-4251
Mailing address
13131 Brooktree LN
Laurel, MD 20707-9499
Phone (410) 465-0508
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 |
|---|---|---|---|
| 053448-1 | NY | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Dental PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Horizon Dental Center
- General Practice Dentistry
- Forest Hills, NY
- NPI 1730224866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226361600000",
"number": "1073725891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13131 BROOKTREE LN",
"city": "LAUREL",
"state": "MD",
"postal_code": "207079499",
"telephone_number": "410-465-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10750 QUEENS BLVD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754251",
"telephone_number": "718-793-1777",
"fax_number": "718-544-5123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SEOKWOO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2008-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "053448-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.