Individual provider Active NPI

Donald Dong-Cheon Lee, D.D.S.

  • Dentist
  • Centralia, WA
National Provider Identifier
1588979967
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE 60189640 Issued in WA
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

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
25997OtherTXDENTAL 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DE 60189640WAMDDentist
60189640WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.