KYOUNG YUN LEE (NPI# 1508127135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508127135 |
| Entity Type | Individual |
| Full Name | KYOUNG YUN LEE |
| Credential | D.D.S |
| Practice Address |
141 E Pershing Rd Decatur IL 62526-3213 |
| Mailing Address |
651 E 14th St 6e New York NY 10009-3119 |
| Practice Telephone | 2178776559 |
| Mailing Telephone | 9175439132 |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2014-11-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 22DI02568700 | NJ | Dental Providers |
| Y | 122300000X | Dentist | 019029708 | IL | Dental Providers |
| N | 122300000X | Dentist | 010747 | CT | Dental Providers |
| Street Address |
141 E PERSHING RD |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-3213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154932218 | Myoungsu Song | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2020-08-12 |
| 1972120913 | Hong Keun Yoon | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2020-06-25 |
| 1891276341 | Elizabeth Moore | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2018-08-23 |
| 1023561933 | Abhinav Kalra | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2016-07-27 |
| 1154758712 | Youngtak Chi | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2013-09-27 |
| 1568725943 | Decatur 2013 LLC | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2012-06-20 |
| 1003179482 | Decatur 2014 | Dentist | 141 E Pershing Rd, Suite 610, Decatur, IL 62526-3213 | 2012-06-20 |
| 1417210857 | Decatur 2015 LLC | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2012-06-20 |
| 1306107578 | Decatur 2012 LLC | Dentist | 141 E Pershing Rd, Decatur, IL 62526-3213 | 2012-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| 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 |
|---|---|---|---|---|
| 1437763380 | Ah Chong | Dentist | 755 Commerce Dr Ste 513, Decatur, GA 30030-2618 | 2020-09-08 |
| 1891327904 | Vital Smiles Alabama II PC | Dentist | 809 Beltline Rd Sw Ste A, Decatur, AL 35601-6337 | 2020-02-06 |
| 1568001147 | Amanda Nkechinyere Udunka | Dentist | 3106 Robinwood Trl, Decatur, GA 30034-3553 | 2019-12-31 |
| 1972097459 | Ashley Marie Nowdomski | Dentist | 1353 E Mound Rd Ste 101, Decatur, IL 62526-3600 | 2018-06-19 |
| 1639609340 | Zi Jian Wu | Dentist | 2570 Blackmon Dr Ste 310, Decatur, GA 30033-6197 | 2017-06-14 |
| 1780036848 | Smiles of Decatur P.C. | Dentist | 2458 Wesley Chapel Rd Ste B, Decatur, GA 30035-3423 | 2016-07-12 |
| 1093102055 | Kevin Jeffrey Greene | Dentist | 1821 Beltline Rd Sw, Decatur, AL 35601-5506 | 2015-04-16 |
| 1801225479 | Jorge Carlos Griswold | Dentist | 2680 Lawrenceville Hwy Ste 102, Decatur, GA 30033-2526 | 2013-11-04 |
| 1376885343 | Paul Duane Potter | Dentist | 280 W North St, Decatur, IL 62522-2222 | 2013-03-18 |
| 1689953960 | Jennifer Anne Dillon | Dentist | 144 S Columbia Dr, Decatur, GA 30030-4103 | 2011-08-04 |
| Find all providers in DECATUR | ||||
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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.