Active NPI
Sang Yun Lee
- General Practice Dentistry
- Washington DC, DC
National Provider Identifier
1629806898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401419112
- Practice address
- 1301 M St.
Apt 909 NW
Washington DC, DC 20005 - Phone
- (914) 494-8192
- NPI assigned
- Jul 22, 2024
- Last updated
- Jul 22, 2024
- 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 | 0401419112 | VA | Primary |
Addresses
Primary practice location
1301 M St.
Apt 909 NW
Washington DC, DC 20005
Mailing address
110 Charlton St Apt 22C
New York, NY 10014-4089
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 |
|---|---|---|---|
| 0401419112 | VA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1629806898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 CHARLTON ST APT 22C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100144089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 M ST.",
"address_2": "APT 909 NW",
"city": "WASHINGTON DC",
"state": "DC",
"postal_code": "20005",
"telephone_number": "914-494-8192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SANG YUN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-22",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401419112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington DC, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.