Active NPI
Joosang Lee
- Dentist
- Henderson, TX
National Provider Identifier
1922786664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39809
- Practice address
- 1115 US Highway 259 S
Henderson, TX 75654-3629 - Phone
- (903) 392-8251
- NPI assigned
- Jul 11, 2023
- Last updated
- May 22, 2024
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 39809 | TX | Primary |
Addresses
Primary practice location
1115 US Highway 259 S
Henderson, TX 75654-3629
Mailing address
3637 US Highway 259 N Apt 1004
Longview, TX 75605-7781
Phone (412) 708-5791
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 |
|---|---|---|---|
| 39809 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1922786664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3637 US HIGHWAY 259 N APT 1004",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756057781",
"telephone_number": "412-708-5791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 US HIGHWAY 259 S",
"city": "HENDERSON",
"state": "TX",
"postal_code": "756543629",
"telephone_number": "903-392-8251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOOSANG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-11",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "39809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.