Individual provider Active NPI

Yun Je Lee, DMD

  • General Practice Dentistry
  • New Hope, MN
National Provider Identifier
1093445108
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14760 Issued in MN
Practice address
9220 Bass Lake Rd Ste 345
New Hope, MN 55428-3095
Phone
(763) 248-0680
NPI assigned
Jun 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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 D14760 MN Primary

Addresses

Primary practice location

9220 Bass Lake Rd Ste 345
New Hope, MN 55428-3095

Mailing address

6075 Niagara LN N
Plymouth, MN 55446-4540
Phone (763) 248-0680

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
D14760MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Your Dental General Practice CurrentSince Jun 21, 2022 Accepting new patients

Locations

9220 Bass Lake Rd
Ste 345
New Hope, MN 55428
Phone (763) 248-0680

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1093445108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 NIAGARA LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554464540",
            "telephone_number": "763-248-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 BASS LAKE RD STE 345",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283095",
            "telephone_number": "763-248-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YUN",
        "middle_name": "JE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hope, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.