Individual provider Active NPI

Won Gi Lee, D.D.S

  • Dentist
  • Boston, MA
National Provider Identifier
1659792844
Registry record updated Dec 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856229 Issued in MA
Practice address
74 Bay State Rd Apt 7
Boston, MA 02215-1983
Phone
(312) 543-7475
NPI assigned
Dec 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856229 MA Primary

Addresses

Primary practice location

74 Bay State Rd Apt 7
Boston, MA 02215-1983

Mailing address

74 Bay State Rd Apt 7
Boston, MA 02215-1983
Phone (312) 543-7475

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160322002288 MA Order and Referring Only - DentistPractitioner - Dentist 3274830096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856229MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1387065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387065600000",
    "number": "1659792844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 BAY STATE RD APT 7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151983",
            "telephone_number": "312-543-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BAY STATE RD APT 7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151983",
            "telephone_number": "312-543-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WON GI",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-15",
        "last_updated": "2013-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.