Beom J Lee, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013393 Issued in GA

Practice address

4855 River Green Pkwy
Suite 110
Duluth, GA 30096-8336

Phone

(770) 500-3757

Fax

(770) 476-4995

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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 GA

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891806444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 110",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "770-500-3757",
            "fax_number": "770-476-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 110",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "770-500-3757",
            "fax_number": "770-476-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BEOM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lech, M.P.T.
• Wendy Ledesma, PA
• Lee Home Care LLC
• Lee Physical Therapy and Rehab Inc
• Abraham Lee, MD
• Brandon Yongjo Lee, L.AC.
• Cassidy Lee
• Christopher J Lee, M.D.
• Da Sol Lee
• Edward Lee

• General Practice Dentistry in Duluth, GA
• Providers in Duluth, GA by specialty
• General Practice Dentistry in Georgia

• 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.