Stefanel Erika Lee Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13220 Issued in CT

Practice address

3741 Main St
Bridgeport, CT 06606-3609

Phone

(475) 282-4912

NPI assigned

Apr 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677974400000",
    "number": "1215510086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063609",
            "telephone_number": "475-282-4912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 Main St",
            "address_purpose": "LOCATION",
            "city": "East Hartford",
            "state": "CT",
            "postal_code": "061082294",
            "country_code": "US",
            "telephone_number": "860-528-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE KIM",
        "first_name": "STEFANEL",
        "middle_name": "ERIKA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "13220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Layda, R.D.
• Le Family Dental Practice P.C
• Victoria Martica Lebinski, LPC
• Delia Lebron, PSYCHOLOGIST
• Karen Lecleir
• Bernice Lee, PHARMD
• Jennifer Lee
• Jin Hee Lee
• Samantha Madison Lee
• Sang Yub Lee, MD

• General Practice Dentistry in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2023; 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.