Soo Yun Stacy Lee, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

13674 Issued in MD

Practice address

10665 Stanhaven PL
Ste 105
White Plains, MD 20695-3060

Phone

(301) 632-5480

Fax

(301) 870-7034

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Neibauer Dental Care, PC

  • General Practice Dentistry
  • White Plains, MD
  • NPI 1629345251
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114015948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 BRINKLEY RD",
            "address_2": "#201",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207487105",
            "telephone_number": "301-870-4553",
            "fax_number": "301-870-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PL",
            "address_2": "STE 105",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953060",
            "telephone_number": "301-632-5480",
            "fax_number": "301-870-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SOO YUN",
        "middle_name": "STACY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "13674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adenike Kupolati, RPH
• Meghan A Lainoff, PA-C
• Kimberly Destefano Larsen, MD
• Shelby Lawanson
• Eileen Leahy, NP
• Shanice Renee Levy
• Ti'Aesha K Lewis
• LHG Global, Intl., Inc.
• Lifetime Dental Care of Maryland, Badger, P.C.
• Lincare Inc.

• Orthodontics and Dentofacial Orthopedics Dentistry in White Plains, MD
• Providers in White Plains, MD by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Maryland

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

Verify at the official NPI Registry.