Individual provider Active NPI

Eugene Y Lee, D.D.S.

  • Pediatric Dentistry
  • Forest Hills, NY
National Provider Identifier
1437140563
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
050692 Issued in NY
Practice address
10460 Queens Blvd
Suite 1F
Forest Hills, NY 11375-7301
Phone
(718) 459-7900
NPI assigned
Oct 28, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 050692 NY Primary

Addresses

Primary practice location

10460 Queens Blvd
Suite 1F
Forest Hills, NY 11375-7301

Mailing address

10460 Queens Blvd
Apt. 2C
Forest Hills, NY 11375-7301
Phone (917) 446-1197

Other identifiers 1

IdentifierTypeStateIssuer
02405163MedicaidNY

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
050692NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiles Perfected Orthodontics Pediatric Dentistry Past Accepting new patients
Simon Cheirif DDS PC Pediatric Dentistry Past Accepting new patients
Eugene Lee, DDS., PC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 3

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437140563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10460 QUEENS BLVD",
            "address_2": "APT. 2C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757301",
            "telephone_number": "917-446-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10460 QUEENS BLVD",
            "address_2": "SUITE 1F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757301",
            "telephone_number": "718-459-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUGENE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "050692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02405163",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.