Active NPI
Dong Hoon Lee, D.M.D
- Dentist
- Louisburg, NC
National Provider Identifier
1174797013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9417
- Practice address
- 109 Jolly St
Louisburg, NC 27549-2239 - Phone
- (919) 496-5734
- Fax
- (919) 496-2599
- NPI assigned
- Apr 22, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS037174 | PA | |
| Dentist | 122300000X | 9417 | NC | Primary |
Addresses
Primary practice location
109 Jolly St
Louisburg, NC 27549-2239
Mailing address
109 Jolly St
Louisburg, NC 27549-2239
Phone (919) 496-5734
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 |
|---|---|---|---|
| 9417 | NC | MD | Dentist |
| DS037174 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357603200000",
"number": "1174797013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 JOLLY ST",
"city": "LOUISBURG",
"state": "NC",
"postal_code": "275492239",
"telephone_number": "919-496-5734",
"fax_number": "919-496-2599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 JOLLY ST",
"city": "LOUISBURG",
"state": "NC",
"postal_code": "275492239",
"telephone_number": "919-496-5734",
"fax_number": "919-496-2599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DONG HOON",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-22",
"last_updated": "2013-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS037174",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "9417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisburg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.