Susan Hae Kyung Lee, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN011872 Issued in GA

Practice address

3280 Howell Mill Rd NW Ste 121
Atlanta, GA 30327-4107

Phone

(404) 355-8557

Fax

(404) 355-8321

NPI assigned

Jul 26, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 11, 2016 through May 11, 2028

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.

• Susan H Lee DMD LLC

  • Pediatric Dentistry
  • Atlanta, GA
  • NPI 1225137045
  NPD (past) Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1124042049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 HOWELL MILL RD NW STE 121",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303274107",
            "telephone_number": "404-355-8557",
            "fax_number": "404-355-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 HOWELL MILL RD NW STE 121",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303274107",
            "telephone_number": "404-355-8557",
            "fax_number": "404-355-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "middle_name": "HAE KYUNG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN011872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000821895D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sojeong Lee, OD
• Soo Jung Lee, OD
• Spencer Lee
• Stedman Lee, PHARMD
• Steven R. Lee, M. D.
• Susan McManus Lee, PH.D.
• Sylvester Jerome Lee
• Tai-Lin Lee
• Theodore Mark Lee, MD
• Tiah Shontaye Lee, RN

• Pediatric Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.