Active NPI
Seung-Jun Lee, D.D.S.
- Periodontics
- Irving, TX
National Provider Identifier
1356691638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 29736
- Practice address
- 2651 Texas Dr
Irving, TX 75062-7016 - Phone
- (972) 255-4164
- Fax
- (972) 252-1580
- NPI assigned
- Sep 14, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 29736 | TX | Primary |
| Periodontics | 1223P0300X | 60903 | CA |
Addresses
Primary practice location
2651 Texas Dr
Irving, TX 75062-7016
Mailing address
2651 Texas Dr
Irving, TX 75062-7016
Phone (972) 255-4164
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 |
|---|---|---|---|
| 29736 | TX | MD | Mental Health Counselor |
| 60903 | CA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404864000000",
"number": "1356691638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2651 TEXAS DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750627016",
"telephone_number": "972-255-4164",
"fax_number": "972-252-1580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2651 TEXAS DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750627016",
"telephone_number": "972-255-4164",
"fax_number": "972-252-1580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SEUNG-JUN",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-14",
"last_updated": "2014-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "29736",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "60903",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.