Daria Hyeri Lee, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901022715 Issued in MI

Practice address

3440 Ohio St
Great Lakes, IL 60088-3155

Phone

(734) 417-7302

NPI assigned

Jul 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Daria Hyeri Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1285120543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 OHIO ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600883155",
            "telephone_number": "734-417-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 OHIO ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600883155",
            "telephone_number": "734-417-7302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17543 Deer Path Dr",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481681874",
            "country_code": "US",
            "telephone_number": "734-417-7302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "DARIA",
        "middle_name": "HYERI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARIA",
            "last_name": "KIM",
            "middle_name": "HYERI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clinton Lariscy, IDC
• Lauren Jayne Lattery, OD, MS
• Don D Lavanway, RPH
• Elinor Grace Layton, DMD
• Marisa Leandro, D.D.S., M.S.
• Marshall Lee, PHARMD
• Norman Lee, M.D.
• Karen Leone, M.D.
• Jon Scott Little, IDC
• Ruth Ann Little, LPN

• Dentist in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.