Grace Ji Yeon Park Lee, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

5582 Issued in AZ

Practice address

1805 W 24TH St
Yuma, AZ 85364-6104

Phone

(928) 726-7041

Fax

(928) 726-2638

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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 AZ

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

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790862548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646104",
            "telephone_number": "928-726-7041",
            "fax_number": "928-726-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646104",
            "telephone_number": "928-726-7041",
            "fax_number": "928-726-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GRACE",
        "middle_name": "JI YEON PARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Eric Lavin, HIS
• Simon Lavotshkin, M.D.
• Edith Clair Lazaro, MSN RN
• Lee D. Hieb, M.D., P.C.
• Erlinda Lee, RN
• Grace Li-Yuen Ho Lee, PA-C
• Jack Jenchieh Lee
• Junghae Lee, CCC-A
• Kate Lee
• Kathryn Lee, LCSW

• Dentist in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.