Active NPI
Michael Minsu Lee, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Saint Louis, MO
National Provider Identifier
1831804772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 2022040748
- Practice address
- 3320 Rutger St
Saint Louis, MO 63104-1122 - Phone
- (314) 977-8600
- NPI assigned
- Jan 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2022040748 | MO | Primary |
Addresses
Primary practice location
3320 Rutger St
Saint Louis, MO 63104-1122
Mailing address
3320 Rutger St
Saint Louis, MO 63104-1122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022040748 | MO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1831804772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3320 RUTGER ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 RUTGER ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041122",
"telephone_number": "314-977-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MICHAEL",
"middle_name": "MINSU",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MO",
"license": "2022040748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.