Eugenie Eunkyung Lee, D.M.D., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI02404500 Issued in NJ

Practice address

230 Centre St
Nutley, NJ 07110-2877

Phone

(973) 661-2992

NPI assigned

Oct 20, 2011

Sex

Female

Sole proprietor

No

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Periollp

  • Periodontics
  • Nutley, NJ
  • NPI 1346541885
  NPD (past)

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1548545676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CENTRE ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 CENTRE ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102877",
            "telephone_number": "973-661-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUGENIE",
        "middle_name": "EUNKYUNG",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02404500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Seth Landsman, DDS
• Alkies Lapas, D.O.
• Robert F Lardiere, DPM
• Lauren Martini OT
• Brandon Michael Lee, LSW
• Leftfield Transportation LLC
• Cynthia Leto-Palangio, ATC
• Daniel Levy, M.D.
• Carly Ann Licameli, M.A., CCC-SLP
• Lifebridge

• Periodontics in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.

Verify at the official NPI Registry.