Kyung Soo Lee, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20885 Issued in TX

Practice address

1311 E Belt Line Rd Ste 3
Carrollton, TX 75006-6279

Phone

(972) 820-0370

NPI assigned

Dec 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Riverside Dental Clinic, P.C.

  • General Practice Dentistry
  • Carrollton, TX
  • NPI 1144367087
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1508048190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 E BELT LINE RD STE 3",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066279",
            "telephone_number": "972-820-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 E BELT LINE RD STE 3",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066279",
            "telephone_number": "972-820-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KYUNG",
        "middle_name": "SOO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeagun Lee
• Jin Kuk Lee, DDS
• Jong H Lee, MD
• Joseph Lee
• Jungseok Lee
• Jamesha Leejay, COTA
• Legacy Therapy Solutions
• Legent Physicians Network
• Marla J Lehmann, PA
• Ronald John Lehrer I, D.C.

• General Practice Dentistry in Carrollton, TX
• Providers in Carrollton, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.