Kevin Seokkyu Lee, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50-052968 Issued in NY

Practice address

1 Barstow Rd Ste P23
Great Neck, NY 11021-3501

Phone

(516) 466-8744

Fax

(516) 829-3650

NPI assigned

Nov 29, 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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• KVL Dental Group P.C.

  • General Practice Dentistry
  • Great Neck, NY
  • NPI 1124205281
  NPD (past) Authorized official
• KHK Dentisrty PC

  • Dentist
  • Oceanside, NY
  • NPI 1225351836
  NPD (past)

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1558543736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARSTOW RD STE P23",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213501",
            "telephone_number": "516-466-8744",
            "fax_number": "516-829-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARSTOW RD STE P23",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213501",
            "telephone_number": "516-466-8744",
            "fax_number": "516-829-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KEVIN",
        "middle_name": "SEOKKYU",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50-052968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Lee, MD
• Jeff Lee
• Jessica Seulgii Lee, P.T.
• Joanne Lee, M.D.
• John Lee, DDS
• Kiseok Lee
• Linda Y Lee, M.D.
• Mabel Lee, RD, CDN, CDCES
• Michael G Lee, PHARM.D
• Michelle Yoon Lee, RPH

• General Practice Dentistry in Great Neck, NY
• Providers in Great Neck, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.