David Blong S Lee DDS SC

Primary specialty

DentistTaxonomy code 122300000X

License

5157 Issued in WI

Legal business name

DAVID BLONG S LEE DDS SC

Practice address

825 Michigan Ave
Sheboygan, WI 53081

Phone

(920) 459-9010

Fax

(920) 459-9272

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. David Blong Shonanou Lee, DDSNPI 1285846592

Title

President

Phone

(920) 459-9010

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Blong Shouanou Lee, DDS

  • Dentist
  • Sheboygan, WI
  • NPI 1285846592
  NPD (past) Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144432469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 MICHIGAN AVE",
            "city": "SEHBOYGAN",
            "state": "WI",
            "postal_code": "53081",
            "telephone_number": "920-459-9010",
            "fax_number": "920-459-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 MICHIGAN AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "53081",
            "telephone_number": "920-459-9010",
            "fax_number": "920-459-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID BLONG S LEE DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVID BLONG",
        "authorized_official_middle_name": "SHONANOU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-459-9010",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "5157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33757100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelique Dambruch, LPC
• Tanya Marie Damrow, MA SAC LPC
• Julia Zhao Dandrow
• Timothy Wayne Danielson, RPH
• Robert Patrick Darling, DDS
• Carolyn A.H. Davis, LPC-IT
• Alicia Davister, PHARMD
• Kelly Dawson, APNP
• Abigail Day
• Susan Katherine Anne De Shazer, LMT, CLT, MLD

• Dentist in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.