Active NPI
Donald Dong-Cheon Lee, D.D.S.
- Dentist
- Centralia, WA
National Provider Identifier
1588979967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE 60189640
- Practice address
- 228 Harrison Ave
Centralia, WA 98531-1324 - Phone
- (909) 528-4292
- NPI assigned
- Aug 10, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 25997 | TX | |
| General Practice Dentistry | 1223G0001X | 60189640 | WA | |
| Dentist | 122300000X | DE 60189640 | WA | Primary |
Addresses
Primary practice location
228 Harrison Ave
Centralia, WA 98531-1324
Mailing address
228 Harrison Ave
Centralia, WA 98531-1324
Phone (909) 528-4292
Other practice location 1
12121 Highway 99
Everett, WA 98204-5516
Phone (425) 355-5233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25997 | Other | TX | DENTAL LICENSE NUMBER |
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
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE 60189640 | WA | MD | Dentist |
| 60189640 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hyodo, Lee, Magelsen & Yi IV, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Airport Way Dental Care
- Dental Clinic/Center
- Everett, WA
- NPI 1821432311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607904000000",
"number": "1588979967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 HARRISON AVE",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985311324",
"telephone_number": "909-528-4292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 HARRISON AVE",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985311324",
"telephone_number": "909-528-4292"
}
],
"practiceLocations": [
{
"address_1": "12121 Highway 99",
"address_purpose": "LOCATION",
"city": "Everett",
"state": "WA",
"postal_code": "982045516",
"country_code": "US",
"telephone_number": "425-355-5233",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "DONALD",
"middle_name": "DONG-CHEON",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-10",
"last_updated": "2020-12-14",
"certification_date": "2020-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "25997",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60189640",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE 60189640",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE NUMBER",
"identifier": "25997",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.