Jung Ho Lee, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60172617 Issued in WA

Practice address

2962 Limited LN NW Ste B
Olympia, WA 98502-4550

Phone

(360) 754-9300

Fax

(360) 754-0220

NPI assigned

Jul 28, 2010

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

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jung Ho Lee, DDS, PLLC

  • General Practice Dentistry
  • Olympia, WA
  • NPI 1427404268
  NPD Authorized official
• Nurani, Mitchell, Kim, PC

  • Dentist
  • Olympia, WA
  • NPI 1699110494
  NPD (past)

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1982918223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 KINGSBURY LN SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985013082",
            "telephone_number": "360-754-9300",
            "fax_number": "360-754-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2962 LIMITED LN NW STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024550",
            "telephone_number": "360-754-9300",
            "fax_number": "360-754-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUNG HO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60172617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chataqua Lee
• Crystal Ann Lee
• Hyaera Lee, RPH
• Jae Hun Lee, PHARM.D.
• Jenny Lee, PHARM.D.
• Justin Lee, MSC., MSC., M.D.,
• Justin S Lee, DDS
• Ken P Lee, M.D.
• Lianka D Lee, DAIM
• Lisa A Lee, MD

• General Practice Dentistry in Olympia, WA
• Providers in Olympia, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.