Jeonglee Dmdpc Inc

Primary specialty

DentistTaxonomy code 122300000X

License

DN1855209 Issued in MA

Legal business name

JEONGLEE DMDPC INC

Practice address

452 Pleasant St
#110
Malden, MA 02148-8117

Phone

(781) 322-4914

NPI assigned

Nov 5, 2015

Last updated

Nov 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeong Sook Lee

Title

Dentist

Phone

(781) 322-4914

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1245603836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 PLEASANT ST",
            "address_2": "#110",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021488117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 PLEASANT ST",
            "address_2": "#110",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021488117",
            "telephone_number": "781-322-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEONGLEE DMDPC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JEONG SOOK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "781-322-4914"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Malden, MA
• Providers in Malden, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.