Kyle Kyoungroh Lee, is a
Dentist - General Practice based in Deep River, Connecticut. Kyle Kyoungroh Lee is licensed to practice in Connecticut (license number 14130) and his current practice location is
199 Main St, Deep River, Connecticut. He can be reached at his office (for appointments etc.) via phone at
(860) 526-9519.
NPI number for Kyle Kyoungroh Lee is 1639879943 and his current mailing address is 199 Main St, Deep River, Connecticut. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1639879943.
Healthcare Provider's Profile
| Full Name | Kyle Kyoungroh Lee |
|---|
| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 199 Main St, Deep River, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1639879943
- Provider Enumeration Date: 03/06/2023
- Last Update Date: 09/13/2024
Medical Identifiers
Medical identifiers for Kyle Kyoungroh Lee such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1639879943 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1223G0001X | Dentist - General Practice | 14130 (Connecticut) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kyle Kyoungroh Lee is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Kyle Kyoungroh Lee, 199 Main St, Deep River, CT 06417-2021 Ph: (860) 526-9519 | Kyle Kyoungroh Lee, 199 Main St, Deep River, CT 06417-2021 Ph: (860) 526-9519 |
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