Clara Taeyoon Lee

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

NA Issued in NY

Practice address

82-68 164TH St
N Building Room 633
Queens, NY 11432

Phone

(718) 883-3000

NPI assigned

Mar 26, 2019

Last updated

Apr 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 16, 2022 through Aug 16, 2026

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• The Dental Family Junior

  • Dental Clinic/Center
  • Cranford, NJ
  • NPI 1578001988
  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1942761648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 CRESCENT ST APT 1810",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014260",
            "telephone_number": "347-921-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82-68 164TH ST",
            "address_2": "N BUILDING ROOM 633",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-883-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CLARA",
        "middle_name": "TAEYOON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctl318@nyu.edu",
            "affiliation": "N",
            "endpointDescription": "school email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "82-68 164th St",
            "address_2": "N Building Room 633",
            "city": "Queens",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mahi-Ruhi Ladhani Jain, PA-C
• Sabrina Denae Lagreca, CCC-SLP
• Jessica Lanzkowsky
• Paul Richard Larrow, LMSW LCSW
• Hannah Peta Lawson
• Briana Lenna, OTR/L
• Tenzin Lhanzay
• Life-Cycles Midwifery Healthcare Services, P.C. (My Midwife Woman's Healthcare Services)
• Hodaya Rachel Lightstone, DNP
• Daban Lim

• General Practice Dentistry in Queens, NY
• Providers in Queens, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.