Individual provider Active NPI

Eugene Yunsung Lee, D.D.S.

  • Prosthodontics
  • Lake Oswego, OR
National Provider Identifier
1326574203
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
D12261 Issued in OR
Practice address
4004 Kruse Way PL Ste 125
Lake Oswego, OR 97035-2493
Phone
(650) 430-7099
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X D12261 OR Primary
Prosthodontics 1223P0700X 105703 CA

Addresses

Primary practice location

4004 Kruse Way PL Ste 125
Lake Oswego, OR 97035-2493

Mailing address

3570 S River Pkwy Unit 1611
Portland, OR 97239-4544
Phone (650) 430-7099

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

LicenseStateTypeSpecialty
105703CAMDProsthodontist
D12261ORMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1326574203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 S RIVER PKWY UNIT 1611",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394544",
            "telephone_number": "650-430-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 KRUSE WAY PL STE 125",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352493",
            "telephone_number": "650-430-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUGENE",
        "middle_name": "YUNSUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OR",
            "license": "D12261",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "105703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.