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Dr. Jiyoung Elizabeth Lee , DMD

Dentist - Pediatric Dentistry β€’ Gresham, OR

Active NPI 1477567154 Individual Practitioner Female Practitioner
Practice location in NPPES

831 Nw Council Dr Ste 210
Gresham, OR 970303724

Call 5036669436 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

831 Nw Council Dr Ste 210

Gresham, OR 970303724

Telephone 5036669436
Fax 5039120757
Organization at the Same NPPES Address or Phone
Jiyoung E Lee Dmd Pc Facility NPI 1942573118

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Gresham and Oregon

6 active clinicians are listed under Dentist - Pediatric Dentistry with a practice address in Gresham, OR (172 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-06-15
Dentist - Pediatric Dentistry Primary Specialty

NUCC Taxonomy Code: 1223P0221X

License # reported to NPPES OR D8776

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.

Dentist - Pediatric Dentistry

NUCC Taxonomy Code: 1223P0221X

License # reported to NPPES MA 20808

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Omap
028475 (OR)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location June 15, 2020

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

πŸ“
Updated Business Mailing Address June 15, 2020

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

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2020

Dentist (license number reported to NPPES: MA 20808)

βœ…
NPI Profile Active February 16, 2012

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 16, 2012

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

πŸ“
Business Mailing Address (Initial Record) February 16, 2012

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

πŸ‘€
Provider Name / Credentials (Initial Record) February 16, 2012

Recorded as JIYOUNG LEE, DMD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2012

Dentist (license number reported to NPPES: OR D8776)

🟒
Initial NPI Registration & Enumeration July 28, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1477567154
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2006
Last Update: June 15, 2020
Sole Proprietor: Yes

Mailing Address

831 Nw Council Dr Ste 210

Gresham, OR 970303724

Phone: 5036669436

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.