Active NPI
Sung Eun Lee, DDS
- General Practice Dentistry
- Crofton, MD
National Provider Identifier
1265443469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13790
- Practice address
- 1286 Maryland RT 3 S Ste 7
Crofton, MD 21114-1340 - Phone
- (410) 721-8200
- Fax
- (410) 721-7629
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13790 | MD | Primary |
Addresses
Primary practice location
1286 Maryland RT 3 S Ste 7
Crofton, MD 21114-1340
Mailing address
926 Great Pond Dr
Suite 2003
Altamonte Springs, FL 32714-7244
Phone (407) 772-5124
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 |
|---|---|---|---|
| 13790 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1265443469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "926 GREAT POND DR",
"address_2": "SUITE 2003",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327147244",
"telephone_number": "407-772-5124",
"fax_number": "407-788-3572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1286 MARYLAND RT 3 S STE 7",
"city": "CROFTON",
"state": "MD",
"postal_code": "211141340",
"telephone_number": "410-721-8200",
"fax_number": "410-721-7629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SUNG",
"middle_name": "EUN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "13790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crofton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.