Active NPI
Peter Sae Lee, DDS
- Dentist
- Leesburg, VA
National Provider Identifier
1952454688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401410099
- Practice address
- 2 Cardinal Park Dr SE
Suite 206-a
Leesburg, VA 20175-4448 - Phone
- (703) 771-1515
- Fax
- (703) 771-8242
- NPI assigned
- Jan 18, 2007
- Last updated
- Jul 8, 2007
- 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 | 0401410099 | VA | Primary |
Addresses
Primary practice location
2 Cardinal Park Dr SE
Suite 206-a
Leesburg, VA 20175-4448
Mailing address
2 Cardinal Park Dr SE
Suite 206-a
Leesburg, VA 20175-4448
Phone (703) 771-1515
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 |
|---|---|---|---|
| 0401410099 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sue K Moon DDS PC | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952454688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CARDINAL PARK DR SE",
"address_2": "SUITE 206-A",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201754448",
"telephone_number": "703-771-1515",
"fax_number": "703-771-8242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CARDINAL PARK DR SE",
"address_2": "SUITE 206-A",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201754448",
"telephone_number": "703-771-1515",
"fax_number": "703-771-8242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "PETER",
"middle_name": "SAE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401410099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.