Ivy Dental for Kids

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9491 Issued in WA

Legal business name

IVY DENTAL FOR KIDS

Practice address

18623 Hwy 99
Suite 210
Lynnwood, WA 98037-4552

Phone

(425) 275-9977

Fax

(425) 275-9979

NPI assigned

May 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Yoon Lee, DDS

Title

Dentist

Phone

(425) 275-9977

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639381874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18623 HWY 99",
            "address_2": "SUITE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374552",
            "telephone_number": "425-275-9977",
            "fax_number": "425-275-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18623 HWY 99",
            "address_2": "SUITE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374552",
            "telephone_number": "425-275-9977",
            "fax_number": "425-275-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY DENTAL FOR KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "YOON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "425-275-9977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5041611",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lonnie Isaac
• Debra Susan Islas, LMP
• Miracle Israel
• Kerry Itami, DACHM, LAC, EAMP
• Addison Marie Iverson
• Aya Iwai, D.V.M.
• Naghmeh J Izadi, DMD
• J. Lo Eyecare
• J.a. Denture Clinic LLC (J.A. Dental Laboratory)
• J.D. Moody, P.C. (Affordable Dentures & Implants - Lynnwood)

• General Practice Dentistry in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.