Active NPI
Sang Yoon Lee, D.D.S.
- General Practice Dentistry
- Bloomfield, NJ
National Provider Identifier
1093864597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI02174800
- Practice address
- 270 Belleville Avenue
Dental Office of Dr Lee Sang
Bloomfield, NJ 07003 - Phone
- (973) 259-9600
- Fax
- (973) 259-9700
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02174800 | NJ | Primary |
Addresses
Primary practice location
270 Belleville Avenue
Dental Office of Dr Lee Sang
Bloomfield, NJ 07003
Mailing address
270 Belleville Ave
Bloomfield, NJ 07003
Phone (973) 259-9600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0027651 | Medicaid | NJ |
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 |
|---|---|---|---|
| 22DI02174800 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093864597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "270 BELLEVILLE AVE",
"city": "BLOOMFIELD",
"state": "NJ",
"postal_code": "07003",
"telephone_number": "973-259-9600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 BELLEVILLE AVENUE",
"address_2": "DENTAL OFFICE OF DR LEE SANG",
"city": "BLOOMFIELD",
"state": "NJ",
"postal_code": "07003",
"telephone_number": "973-259-9600",
"fax_number": "973-259-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SANG",
"middle_name": "YOON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02174800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0027651",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.