Active NPI
Gaeun Lee, D.M.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Paterson, NJ
National Provider Identifier
1447548508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 22DI02420100
- Practice address
- 21 Market St
Paterson, NJ 07501-1723 - Phone
- (973) 754-4200
- NPI assigned
- Jul 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 59000111 | NY | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 22DI02420100 | NJ | Primary |
Addresses
Primary practice location
21 Market St
Paterson, NJ 07501-1723
Mailing address
21 Market St
Paterson, NJ 07501-1723
Phone (973) 754-4200
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 |
|---|---|---|---|
| 22DI02420100 | NJ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 59000111 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331683200000",
"number": "1447548508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 MARKET ST",
"city": "PATERSON",
"state": "NJ",
"postal_code": "075011723",
"telephone_number": "973-754-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 MARKET ST",
"city": "PATERSON",
"state": "NJ",
"postal_code": "075011723",
"telephone_number": "973-754-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "GAEUN",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-11",
"last_updated": "2012-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "59000111",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NJ",
"license": "22DI02420100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paterson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.