Active NPI
Justin S Lee, DDS
- General Practice Dentistry
- Olympia, WA
National Provider Identifier
1881616332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE9014
- Practice address
- 3250 14TH Ave NW Ste a
Olympia, WA 98502-8546 - Phone
- (360) 866-7669
- NPI assigned
- Jul 24, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE9014 | WA | Primary |
Addresses
Primary practice location
3250 14TH Ave NW Ste a
Olympia, WA 98502-8546
Mailing address
3250 14TH Ave NW Ste a
Olympia, WA 98502-8546
Phone (360) 866-7669
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 |
|---|---|---|---|
| DE9014 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Gu Im DDS PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sunrise Dental of Olympia
- General Practice Dentistry
- Olympia, WA
- NPI 1205792215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392163200000",
"number": "1881616332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3250 14TH AVE NW STE A",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985028546",
"telephone_number": "360-866-7669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 14TH AVE NW STE A",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985028546",
"telephone_number": "360-866-7669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JUSTIN",
"middle_name": "S",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2014-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE9014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.