Jungwoo Lee, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

20719 Issued in MA

Practice address

616 Fellsway
2ND FL
Medford, MA 02155-4959

Phone

(781) 306-9644

Fax

(781) 306-9726

NPI assigned

Apr 20, 2007

Last updated

Nov 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wellington Circle Dental PC

  • General Practice Dentistry
  • Medford, MA
  • NPI 1568690808
  Authorized official Same address or phone

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1659598407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FELLSWAY",
            "address_2": "2ND FL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554959",
            "telephone_number": "781-306-9644",
            "fax_number": "781-306-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 FELLSWAY",
            "address_2": "2ND FL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554959",
            "telephone_number": "781-306-9644",
            "fax_number": "781-306-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUNGWOO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "20719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vy Le, DPT
• Thomas A. Leavitt, OD
• Anne Elizabeth Lebowitz, MSW LICSW
• Shari Lecker, M.D.
• Jack Ssu-Chieh Lee, D.M.D.
• Leanne Lee, M.D.
• Gerald B. Leiber, D.M.D.
• Joan Mary Lemler, LICSW
• Janet Ann Lensing, OTR
• Stephen Martin Lentine Jr., DMD

• Dentist in Medford, MA
• Providers in Medford, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.

Verify at the official NPI Registry.