Organization Active NPI

DC Light Dental, PC

  • Dentist
  • Washington, DC
National Provider Identifier
1144631706
Registry record updated May 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN 100768 Issued in DC
Legal business name
DC LIGHT DENTAL, PC
Practice address
1331 Pennsylvania Ave NW Ste 502
Washington, DC 20004-1771
Phone
(202) 347-0100
Fax
(202) 347-3703
NPI assigned
May 16, 2014
Last updated
May 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2014

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

Authorized official

Name
Dr. Jong Lee
Title
President
Phone
(202) 347-0100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN 100768 DC Primary
Pediatric Dentistry 1223P0221X DEN1001330 DC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DEN1001175 DC

Addresses

Primary practice location

1331 Pennsylvania Ave NW Ste 502
Washington, DC 20004-1771

Mailing address

1331 Pennsylvania Ave NW Ste 502
Washington, DC 20004-1771
Phone (202) 347-0100

National Provider Directory

National Provider Directory

Locations

1331 Pennsylvania Ave NW
Ste 502
Washington, DC 20004
Phone (202) 347-0100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1144631706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 PENNSYLVANIA AVE NW STE 502",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200041771",
            "telephone_number": "202-347-0100",
            "fax_number": "202-347-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 PENNSYLVANIA AVE NW STE 502",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200041771",
            "telephone_number": "202-347-0100",
            "fax_number": "202-347-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DC LIGHT DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-16",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-347-0100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN 100768",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DC",
            "license": "DEN1001330",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DC",
            "license": "DEN1001175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.