Active NPI
Sujeong Lee, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Pasadena, MD
National Provider Identifier
1093381139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 18411
- Practice address
- 8092 Edwin Raynor Blvd
Pasadena, MD 21122-6833 - Phone
- (718) 579-6095
- NPI assigned
- May 30, 2021
- Last updated
- Apr 8, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 18411 | MD | Primary |
Addresses
Primary practice location
8092 Edwin Raynor Blvd
Pasadena, MD 21122-6833
Mailing address
234 E 149TH St
Bronx, NY 10451-5504
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 |
|---|---|---|---|
| 18411 | MD | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744070400000",
"number": "1093381139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 E 149TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104515504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8092 EDWIN RAYNOR BLVD",
"city": "PASADENA",
"state": "MD",
"postal_code": "211226833",
"telephone_number": "718-579-6095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SUJEONG",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-30",
"last_updated": "2025-04-08",
"certification_date": "2025-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MD",
"license": "18411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.