Active NPI
Sung Min Lee, D.D.S
- Periodontics
- Lawrenceville, NJ
National Provider Identifier
1619124633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 22DI02376100
- Practice address
- 34 Franklin Corner Rd
Lawrenceville, NJ 08648-2102 - Phone
- (098) 883-6900
- NPI assigned
- Aug 20, 2008
- Last updated
- Mar 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 054195-01 | NY | |
| Periodontics | 1223P0300X | 22DI02376100 | NJ | Primary |
Addresses
Primary practice location
34 Franklin Corner Rd
Lawrenceville, NJ 08648-2102
Mailing address
2030 Hudson St Apt 723
Fort Lee, NJ 07024-7218
Phone (201) 638-2071
Other names 1
- Dr. Sung Min Lee
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02376100 | NJ | MD | Periodontist |
| 054195-01 | NY | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miller Dental Arts, P.a. | Past | Accepting new patients |
Interoperability endpoints
- sml7007@direct.nyp.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- West New York, NJ
- NPI 1619019221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1619124633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2030 HUDSON ST APT 723",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070247218",
"telephone_number": "201-638-2071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 FRANKLIN CORNER RD",
"city": "LAWRENCEVILLE",
"state": "NJ",
"postal_code": "086482102",
"telephone_number": "098-883-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SUNG MIN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2023-03-09",
"certification_date": "2023-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "054195-01",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "22DI02376100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUNG",
"last_name": "LEE",
"middle_name": "MIN",
"prefix": "DR.",
"credential": "D.D.S",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Lawrenceville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.