Individual provider Active NPI

Daniel Dongkyu Lee, DMD

  • General Practice Dentistry
  • Lynn, MA
National Provider Identifier
1588808117
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855049 Issued in MA
Practice address
140 Union Street
Suite 303
Lynn, MA 01901-1326
Phone
(781) 592-4438
Fax
(781) 593-1930
NPI assigned
Apr 27, 2009
Last updated
Apr 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1855049 MA Primary

Addresses

Primary practice location

140 Union Street
Suite 303
Lynn, MA 01901-1326

Mailing address

140 Union St Ste 303
Lynn, MA 01901-1326
Phone (781) 592-4438

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

LicenseStateTypeSpecialty
DN1855049MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Dentistry, LLC General Practice Current Accepting new patients
Adults & Children Dental Care General Practice Past Accepting new patients

Locations

348 N Pearl St
Brockton, MA 02301
Phone (508) 584-3278

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1588808117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 UNION ST STE 303",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011326",
            "telephone_number": "781-592-4438",
            "fax_number": "781-593-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 UNION STREET",
            "address_2": "SUITE 303",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011326",
            "telephone_number": "781-592-4438",
            "fax_number": "781-593-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DANIEL",
        "middle_name": "DONGKYU",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.