Joon Lee, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21597 Issued in MA

Practice address

11 Tobias Boland Way # 105
Worcester, MA 01607-2108

Phone

(508) 752-1111

Fax

(508) 752-4111

NPI assigned

May 15, 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 MA

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

State licenses

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1558577304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TOBIAS BOLAND WAY # 105",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016072108",
            "telephone_number": "508-752-1111",
            "fax_number": "508-752-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 TOBIAS BOLAND WAY # 105",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016072108",
            "telephone_number": "508-752-1111",
            "fax_number": "508-752-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Jihwan Lee
• Je Hong Lee, DDS
• Jeanna Rae Lee, PHD
• Jieun Lee, PHD
• Jin Lee
• Josaphat Lee
• Julie Lee, DPM
• Mary Min-Chin Lee, M.D.
• Nancy Lee, M.D.
• Paul Lee, PTA

• General Practice Dentistry in Worcester, MA
• Providers in Worcester, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.