John Lee, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

057284 Issued in NY

Practice address

23 Bond St
Great Neck, NY 11021-2019

Phone

(516) 482-0329

NPI assigned

Aug 4, 2011

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 10, 2022 through Jun 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rodney Rastegar DDS PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Garden City, NY
  • NPI 1508195975
  NPD (past)

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1811276132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BOND ST",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212019",
            "telephone_number": "516-482-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BOND ST",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212019",
            "telephone_number": "516-482-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "057284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlie Lee, PHARM D.
• Grace Lee, MD
• Jeff Lee
• Jessica Seulgii Lee, P.T.
• Joanne Lee, M.D.
• Kevin Seokkyu Lee, D.D.S.
• Kiseok Lee
• Linda Y Lee, M.D.
• Mabel Lee, RD, CDN, CDCES
• Michael G Lee, PHARM.D

• Oral and Maxillofacial Surgery (Dentist) in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.