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MOONHYOUNG LEE DDS
NPI 1396438412
Dentist - General Practice in Janesville, WI

Active since June 02, 2023PECOS Enrolled
2630 LIBERTY LN, JANESVILLE, WI 53545(608) 752-2931 Get Directions Write a Review

NPPES record last updated: June 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Moonhyoung Lee Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOONHYOUNG LEE DDS (NPI 1396438412) is an individual general practice provider in Janesville, Wisconsin, licensed in Wisconsin (PENDING) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396438412
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameMOONHYOUNG LEECredential: DDS
Location Address2630 LIBERTY LNJanesville, WI 53545-0717
Mailing Address1868 E Washington Ave, Apt 658Madison, WI 53704 · (813) 767-8389
Phone(608) 752-2931
Sole ProprietorYes
Enumeration DateJune 2, 2023
NPPES CertifiedApril 9, 2023
✔ NPI 1396438412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WI · PENDING
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
2630 LIBERTY LN, Janesville, WI 53545
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moonhyoung Lee Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53545 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GUILLERMO MANUEL ACEVES JR. DDS
Dentist
2630 LIBERTY LN
JANESVILLE, WI 53545
Rock County (608) 752-2931
KIRSTIN MARCKS DDS
Dentist
2630 LIBERTY LN
JANESVILLE, WI 53545
Rock County (608) 752-2931
DR. MAXWELL MIGUEL MINDIOLA DDS
Dentist
2630 LIBERTY LN
JANESVILLE, WI 53545
Rock County (608) 752-2931

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moonhyoung Lee's NPI number?

The NPI number for Moonhyoung Lee is 1396438412. It was assigned to this individual provider in the NPPES registry on June 2, 2023.

Where is Moonhyoung Lee located?

Moonhyoung Lee practices at 2630 Liberty Ln, Janesville, WI 53545. The listed phone number is (608) 752-2931.

What is Moonhyoung Lee's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Moonhyoung Lee enrolled in Medicare?

Yes. Moonhyoung Lee is registered in the Medicare PECOS enrollment system.

What insurance does Moonhyoung Lee accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Moonhyoung Lee as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Moonhyoung Lee was last updated on June 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.