Active NPI
Daniel Dongjun Lee, D.M.D.
- General Practice Dentistry
- Norfolk, VA
National Provider Identifier
1639522105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401415340
- Practice address
- 1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803 - Phone
- (757) 953-8635
- NPI assigned
- Jul 19, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 0401415340 | VA | Primary |
Addresses
Primary practice location
1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803
Mailing address
1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803
Phone (757) 953-8635
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 |
|---|---|---|---|
| 0401415340 | VA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468886400000",
"number": "1639522105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1647 ADMIRAL TAUSSIG BLVD",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235112803",
"telephone_number": "757-953-8635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1647 ADMIRAL TAUSSIG BLVD",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235112803",
"telephone_number": "757-953-8635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DANIEL",
"middle_name": "DONGJUN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-19",
"last_updated": "2016-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401415340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.