Active NPI
Seung Hyup Lee
- Dentist
- Las Vegas, NV
National Provider Identifier
1477256188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7813
- Practice address
- 1001 Shadow LN
Las Vegas, NV 89106-4124 - Phone
- (702) 774-2415
- NPI assigned
- Mar 22, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 7813 | NV | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1001 Shadow LN
Las Vegas, NV 89106-4124
Mailing address
1451 Como Dr
Manteca, CA 95337-8472
Phone (408) 205-4574
Other practice location 1
1451 Como Dr
Manteca, CA 95337-8472
Phone (408) 205-4574
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 |
|---|---|---|---|
| 7813 | NV | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J Lee Dental LLC | Multi-Specialty | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1477256188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1451 COMO DR",
"city": "MANTECA",
"state": "CA",
"postal_code": "953378472",
"telephone_number": "408-205-4574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 SHADOW LN",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064124",
"telephone_number": "702-774-2415"
}
],
"practiceLocations": [
{
"address_1": "1451 Como Dr",
"address_purpose": "LOCATION",
"city": "Manteca",
"state": "CA",
"postal_code": "953378472",
"country_code": "US",
"telephone_number": "408-205-4574",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "SEUNG",
"middle_name": "HYUP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-22",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "7813",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.