KYUNGSANG LEE (NPI# 1336701606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336701606 |
| Entity Type | Individual |
| Full Name | KYUNGSANG LEE |
| Credential | DDS |
| Practice Address |
1 Southtowne Dr Potosi MO 63664 |
| Mailing Address |
1 Southtowne Dr Potosi MO 63664-5729 |
| Practice Telephone | 5734389355 |
| Mailing Telephone | 5734389355 |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2019040973 | MO | Dental Providers |
| N | 122300000X | Dentist | 35266 | TX | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Southtowne Dr, Potosi, MO 63664 | 5734389355 |
| Street Address |
1 SOUTHTOWNE DR |
| City | POTOSI |
| State | MO |
| Zip Code | 63664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386631596 | Marianne Klemm | Family Medicine | 1 Southtowne Dr, Suite B, Potosi, MO 63664-5729 | 2005-10-03 |
| 1144831124 | Kristin R Jennings | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2020-08-12 |
| 1124648423 | Penny Kaye Grechus | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2020-04-16 |
| 1447893003 | Emily Morgan Kelley | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-10-25 |
| 1093367591 | Jill Bleything | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-07-15 |
| 1992367213 | Shannon Michelle Leftridge | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-07-08 |
| 1033683354 | Gregory A Roeback | Counselor | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-01-21 |
| 1205318490 | Terra Renee Graves | Social Worker | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2018-09-04 |
| 1578092797 | Brittany Nicole Helms | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2017-06-10 |
| 1144756966 | Nicholas Veenstra | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2017-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083017461 | Carolyn Coyne Maryan | Specialist/Technologist | 400 Mine St., Citadel School, Potosi, MO 63664 | 2014-09-30 |
| 1205073665 | Potosi Chiropractic Life Center | Chiropractor | 502 North Missouri St., Potosi, MO 63664 | 2009-01-07 |
| 1932385952 | Simpelo Medical Clinic, P.C. | Internal Medicine | 108 Frizzell, Suite 6, Potosi, MO 63664 | 2008-01-22 |
| 1760696918 | Brett T Snodgrass | General Practice | 1 Southtowne Dr., Great Mines Health Center, Potosi, MO 63664 | 2007-05-09 |
| 1710032297 | Washington County Handicapped Services Adult Day Health Care | Day Training, Developmentally Disabled Services | 10604 West Highway E, Potosi, MO 63664 | 2007-01-24 |
| 1578629473 | Greenlee Chiropractic Inc. | Chiropractor | Greenlee Chiropractic, 417 East High St, Potosi, MO 63664 | 2006-12-28 |
| 1003981895 | James Daley Robart Jr. | Chiropractor | 912 N Missouri St, Potosi, MO 63664 | 2006-11-21 |
| 1225063407 | Seth Paskon | Internal Medicine | Potosi Medical Clinic, #1 Kwan Plaza, Potosi, MO 63664 | 2006-07-12 |
| 1346295607 | Donna Yates | Nurse Practitioner | 600 Purcell Dr, Suite B, Potosi, MO 63664 | 2006-05-24 |
| 1467424788 | Washington County Memorial Hospital | Clinic/Center | 108 Frizzell Street, Potosi, MO 63664 | 2006-02-02 |
| Find all providers in zip 63664 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679754790 | Nikodem and Hill Family Dental and Ortho | Dentist | 200 Health Way Dr Ste 1, Potosi, MO 63664-1447 | 2007-11-16 |
| 1790820587 | Edward William Lake | Dentist | 313 E High St, Potosi, MO 63664-1924 | 2007-02-20 |
| 1093367591 | Jill Bleything | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-07-15 |
| 1144756966 | Nicholas Veenstra | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2017-05-11 |
| 1346698396 | Jeffery Johnson | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2016-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649883505 | Kameris Austin-biggs | Dentist | 3500 Jeffco Blvd Ste 100, Arnold, MO 63010-6122 | 2020-08-28 |
| 1003428335 | Ralph Thomas Dinges | Dentist | 7124 S Outer 364, O Fallon, MO 63368-7756 | 2020-08-18 |
| 1093326670 | Amani Abdulateef | Dentist | 4016 Lemay Ferry Rd, Saint Louis, MO 63129-1858 | 2020-08-16 |
| 1033728407 | Sarah Giacomini | Dentist | 1520 S 5th St Ste 103, Saint Charles, MO 63303-4127 | 2020-07-30 |
| 1225647704 | James Andrew Kleoppel | Dentist | 3320 Ne Ralph Powell Rd., Lee's Summit, MO 64064 | 2020-07-30 |
| 1912516923 | Richard Houston Rash | Dentist | 303 N Keene St Ste 202-210, Columbia, MO 65201-8050 | 2020-07-26 |
| 1043828627 | Tara Elizabeth Habibi | Dentist | 3422 Utah St Fl 2, Saint Louis, MO 63118-2727 | 2020-07-20 |
| 1053929778 | Travis Barrett | Dentist | 729 Winding Bluffs Dr, Fenton, MO 63026-5564 | 2020-07-20 |
| 1952929614 | Brianna Buchheit | Dentist | 701 E Market Pkwy, Belton, MO 64012 | 2020-07-09 |
| 1467079707 | Amber Arshad | Dentist | 3901 S Bolger Rd, Independence, MO 64055-6779 | 2020-07-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.