Active NPI
Dong S Lee, D.M.D
- Endodontics
- Owings Mills, MD
National Provider Identifier
1245217447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 13964
- Practice address
- 25 Crossroads Dr Ste 147
Owings Mills, MD 21117-5485 - Phone
- (410) 363-7090
- NPI assigned
- Dec 29, 2005
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 21059 | MA | |
| Endodontics | 1223E0200X | 13964 | MD | Primary |
Addresses
Primary practice location
25 Crossroads Dr Ste 147
Owings Mills, MD 21117-5485
Mailing address
7734 Elmwood Rd
Fulton, MD 20759-2503
Phone (617) 388-7393
Other practice location 1
US Army Dental Clinic, CP Humphreys
618th Dental Co Unit #15660
Apo, AP 96271
KR
Phone 7536573
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 |
|---|---|---|---|
| 13964 | MD | MD | Endodontist |
| 21059 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hero Endodontics | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Owings Mills, MD
- NPI 1306182472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1245217447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7734 ELMWOOD RD",
"city": "FULTON",
"state": "MD",
"postal_code": "207592503",
"telephone_number": "617-388-7393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 CROSSROADS DR STE 147",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211175485",
"telephone_number": "410-363-7090"
}
],
"practiceLocations": [
{
"address_1": "US Army Dental Clinic, CP Humphreys",
"address_2": "618th Dental Co Unit #15660",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AP",
"postal_code": "96271",
"country_code": "KR",
"telephone_number": "7536573",
"country_name": "Korea, Republic of",
"address_type": "FGN"
}
],
"basic": {
"last_name": "LEE",
"first_name": "DONG",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-29",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "21059",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MD",
"license": "13964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owings Mills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.