Active NPI
Tae Joon Lee
- General Practice Dentistry
- Jamaica, NY
National Provider Identifier
1952901993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 062399
- Practice address
- 9012 161St St
Jamaica, NY 11432-6108 - Phone
- (718) 658-0123
- NPI assigned
- Oct 29, 2020
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 062399 | NY | Primary |
Addresses
Primary practice location
9012 161St St
Jamaica, NY 11432-6108
Mailing address
9012 161St St
Jamaica, NY 11432-6108
Phone (718) 658-0123
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 |
|---|---|---|---|
| 062399 | NY | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DP Dental Care, PLLC | General Practice | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1952901993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9012 161ST ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114326108",
"telephone_number": "718-658-0123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9012 161ST ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114326108",
"telephone_number": "718-658-0123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "TAE JOON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-29",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "062399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.