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Active NPI 1942573118 Organization (Entity Type 2)

Jiyoung E Lee Dmd Pc

Dentist - Pediatric Dentistry • Gresham, OR

About Jiyoung E Lee Dmd Pc NPI 1942573118 Summary

Jiyoung E Lee Dmd Pc is a verified healthcare organization specializing in Dentist - Pediatric Dentistry operating in Gresham, OR. Located at 831 NW COUNCIL DR STE 210, this facility provides patient care and medical services under National Provider Identifier (NPI) 1942573118.

Administrative operations and authorized compliance are overseen by Jiyoung Lee (Owner).

The facility is associated with 1 linked healthcare practitioner providing clinical services.

Facility Location & Contact Primary Location

Facility Address

831 Nw Council Dr Ste 210

Gresham, OR 970303724

Telephone 5036669436

Authorized Official Information

Authorized Contact Name

Jiyoung Lee , DMD

Title / Role

Owner

Official Telephone

5036669436

Facility Classifications & Specialties

Dentist - Pediatric Dentistry Primary Taxonomy

NUCC Taxonomy Code: 1223P0221X

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

1 Linked

Dr. Jiyoung Lee , DMD NPI 1477567154

Dentist - Pediatric Dentistry

Gresham, OR

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

7 Historical Events

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Updated Practice Location June 23, 2020

Registered at 831 NW COUNCIL DR STE 210, GRESHAM, OR 970303724 (Tel: 5036669436)

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NPI Profile Active February 29, 2016

NPI status registered as active in NPPES database

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Updated Practice Location February 29, 2016

Registered at 2150 NE DIVISION ST STE 201, GRESHAM, OR 970305859 (Tel: 5036669436)

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Updated Business Mailing Address February 29, 2016

Registered at 831 NW COUNCIL DR, STE 210, GRESHAM, OR 970303721 (Tel: 5037612243)

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Organization / Clinic Name Updated February 29, 2016

Operating as JIYOUNG E LEE DMD PC

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 29, 2016

Dentist (License #D8776 in OR)

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Initial NPI Registration & Enumeration February 17, 2012

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

0 Reviews

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NPI Organization Metadata

NPI Number: 1942573118

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: February 17, 2012

Last Update: June 23, 2020

Update or Correct Listing

Mailing Address

831 Nw Council Dr, Ste 210

Gresham, OR 970303721

Phone: 5037612243

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.