Active NPI
Wangsoo Lee
- Periodontics
- Stockbridge, GA
National Provider Identifier
1215558929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN123029
- Practice address
- 239 Village Center Pkwy Ste 200
Stockbridge, GA 30281-5098 - Phone
- (678) 289-0382
- NPI assigned
- May 4, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN123029 | GA | Primary |
Addresses
Primary practice location
239 Village Center Pkwy Ste 200
Stockbridge, GA 30281-5098
Mailing address
750 Avondale Creek Dr Unit 234
Decatur, GA 30032-8413
Phone (216) 577-7722
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 |
|---|---|---|---|
| DN123029 | GA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ragan L Faler, DMD, PC | Periodontics | Past | Accepting new patients |
| Ragan L Faler DMD PC | Periodontics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Periodontics
- Stockbridge, GA
- NPI 1831542083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769040000000",
"number": "1215558929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 AVONDALE CREEK DR UNIT 234",
"city": "DECATUR",
"state": "GA",
"postal_code": "300328413",
"telephone_number": "216-577-7722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 VILLAGE CENTER PKWY STE 200",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302815098",
"telephone_number": "678-289-0382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "WANGSOO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-04",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "GA",
"license": "DN123029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.