Sang Jin Lee, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

21084 Issued in MA

Practice address

344 Main Street
Hyannis, MA 02601

Phone

(508) 771-7751

Fax

(508) 815-4345

NPI assigned

Nov 11, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1952638017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 MAIN STREET",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "02601",
            "telephone_number": "508-771-7751",
            "fax_number": "508-815-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 MAIN STREET",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "02601",
            "telephone_number": "508-771-7751",
            "fax_number": "508-815-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANG",
        "middle_name": "JIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206949",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Hyannis, MA
• Providers in Hyannis, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.