Active NPI
Jeong Min Lee, DDS
- General Practice Dentistry
- Midland, TX
National Provider Identifier
1598258808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 34215
- Practice address
- 3200 Andrews Hwy Ste 400
Midland, TX 79701-3950 - Phone
- (888) 988-4066
- NPI assigned
- Jun 11, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 34215 | TX | Primary |
Addresses
Primary practice location
3200 Andrews Hwy Ste 400
Midland, TX 79701-3950
Mailing address
636 Brooklyn Ave Apt 5J
Brooklyn, NY 11203-1616
Phone (917) 355-4268
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180905002674 | TX | Order and Referring Only - Dentist | 3476803859 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Midland PLLC | General Practice | 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": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1598258808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 BROOKLYN AVE APT 5J",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112031616",
"telephone_number": "917-355-4268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 ANDREWS HWY STE 400",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797013950",
"telephone_number": "888-988-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JEONG MIN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "34215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.