Individual provider Active NPI

Joosang Lee

  • Dentist
  • District Heights, MD
National Provider Identifier
1285089367
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17713 Issued in MD
Practice address
5570 Silver Hill Rd
District Heights, MD 20747-1104
Phone
(301) 202-2222
NPI assigned
Apr 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 17713 MD Primary
Dentist 122300000X 0401418159 VA

Addresses

Primary practice location

5570 Silver Hill Rd
District Heights, MD 20747-1104

Mailing address

7306 Blade Dr
Falls Church, VA 22042-3234
Phone (808) 748-9608

Other practice location 1

2435 Mandeville Lane, Suite 230
Alexandria, VA 22332
Phone (808) 748-9608

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401418159VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Dental PLLC Dentist CurrentSince Oct 15, 2023 Accepting new patients
Healthy Dental LLC Dentist PastSince Nov 5, 2023 Accepting new patients
Healthy Dental of Hyattsville, LLC Dentist PastSince Nov 5, 2023 Accepting new patients
Dental Dreams PLLC General Practice Past Accepting new patients

Locations

2435 Mandeville Ln
Ste 230
Alexandria, VA 22314
Phone (571) 398-0023

Organizations & group practices 4

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1285089367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7306 BLADE DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423234",
            "telephone_number": "808-748-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5570 SILVER HILL RD",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207471104",
            "telephone_number": "301-202-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2435 Mandeville Lane, Suite 230",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "22332",
            "country_code": "US",
            "telephone_number": "808-748-9608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOOSANG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "17713",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in District Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.