Anthony Kyuhyun Lee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2004013592 Issued in MO

Practice address

708 W Mount Vernon St
Nixa, MO 65714

Phone

(417) 494-5017

Fax

(417) 494-5019

NPI assigned

Aug 29, 2006

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 MO

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

Practice roles

Locations

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.

• Special Care Dental of Missouri LLC

  • Dentist
  • Leawood, KS
  • NPI 1790127512

  MO

  Medicare reassignment NPD
• Smile Up Dental LLC

  • General Practice Dentistry
  • Nixa, MO
  • NPI 1356817340
  NPD (past) Authorized official
• Michelle Dearinger-Davis DDS LLC

  • Dentist
  • Nixa, MO
  • NPI 1548635055
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1831207711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 W MOUNT VERNON ST",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149682",
            "telephone_number": "417-494-5017",
            "fax_number": "417-494-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W MOUNT VERNON ST",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "65714",
            "telephone_number": "417-494-5017",
            "fax_number": "417-494-5019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 NW 10th Ave.",
            "address_purpose": "LOCATION",
            "city": "ava",
            "state": "MO",
            "postal_code": "65608",
            "country_code": "US",
            "telephone_number": "417-683-4831",
            "fax_number": "417-683-1602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANTHONY",
        "middle_name": "KYUHYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2004013592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Christian Larsen, DDS
• Jessica Marie Laughlin, SLPA
• Katelyn Laughlin, RN
• Thyme Calei Lavelle
• Thomas Keith Leclaire, RPH
• Danielle Ranae Lee, NP
• Justin Stephen Legris, M.D.
• Lester E Cox Medical Centers (CoxHealth Nixa Clinic)
• Lester E Cox Medical Centers (CoxHealth Urgent Care Nixa)
• Holly K Letterman-Hitt, FNP-BC

• General Practice Dentistry in Nixa, MO
• Providers in Nixa, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.