Active NPI
Yung Lee, OD, DDS
- Dentist
- Chandler, AZ
National Provider Identifier
1386703692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7366
- Practice address
- 3111 W Chandler Blvd
Suite 1124
Chandler, AZ 85226-5071 - Phone
- (480) 782-9380
- NPI assigned
- Dec 6, 2006
- Last updated
- Sep 11, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 7366 | AZ | Primary |
| Optometrist | 152W00000X | 1583 | AZ |
Addresses
Primary practice location
3111 W Chandler Blvd
Suite 1124
Chandler, AZ 85226-5071
Mailing address
11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170110003348 | AZ | Order and Referring Only - Other (Physician) | 1759461312 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1583 | AZ | MD | Clinical Neuropsychologist |
| 7366 | AZ | MD | Neurology Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tom Sowash OD & Associates PC | Optometrist | Past | Accepting new patients |
| Visionworks Inc | Past | Accepting new patients | |
| Visionworks, Inc | Past | Accepting new patients | |
| Visionworks Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189468800000",
"number": "1386703692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11103 WEST AVE",
"address_2": "SUITE 6",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782131370",
"telephone_number": "210-524-6509",
"fax_number": "210-524-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 W CHANDLER BLVD",
"address_2": "SUITE 1124",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852265071",
"telephone_number": "480-782-9380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "YUNG",
"credential": "OD, DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "7366",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "1583",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.