Individual provider Active NPI

Keehwang Lee, DMD

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1245090810
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10001013 Issued in MA
Practice address
635 Albany St
Boston, MA 02118-3550
Phone
(617) 358-8300
NPI assigned
Mar 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN10001013 MA Primary

Addresses

Primary practice location

635 Albany St
Boston, MA 02118-3550

Mailing address

635 Albany St
Boston, MA 02118-3550
Phone (617) 358-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20260113003151 MA Practitioner - Dentist 3173009727

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

55 Dimock St
Roxbury, MA 02119-1029

800 Market St
Suite 500
Saint Louis, MO 63101-2501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN10001013MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dimock Community Health Center, Inc CurrentSince Jan 26, 2026 Accepting new patients
Dimock Community Health Center, Inc CurrentSince Jan 26, 2026 Accepting new patients

Locations

45 Dimock St
Roxbury, MA 02119

55 Dimock St
Roxbury, MA 02119

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1245090810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183550",
            "telephone_number": "617-358-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183550",
            "telephone_number": "617-358-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KEEHWANG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN10001013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.