Bogun Lee, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

12011478A Issued in IN

Practice address

8079 Madison St
Merrillville, IN 46410-5465

Phone

(219) 769-7855

Fax

(219) 769-7856

NPI assigned

Jun 17, 2010

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

Enrolled in IN

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Dental Professionals of Indiana, P.C.

  • General Practice Dentistry
  • Merrillville, IN
  • NPI 1154543635
  NPD (past)

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1205157815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8079 MADISON ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105465",
            "telephone_number": "219-769-7855",
            "fax_number": "219-769-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8079 MADISON ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105465",
            "telephone_number": "219-769-7855",
            "fax_number": "219-769-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BOGUN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011478A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Lazarevic, PHD
• Anaya Monea Lazaro
• Tatiana Lazic
• Patti Leahy, LCSW
• Hayley Leckner, MA, BCBA
• Nikiea Lee, RBT
• Tomisha Lee
• Virda Lee, PT
• Kelsey Leeb, Ms, Rd
• Abigail Lefler, M.S.ED., ED.S.

• Dentist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.