Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Seongnoh Lee

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1164007092

Seongnoh Lee is an Oral Surgery in Hackensack, New Jersey. Graduated from University of Detroit Mercy School of Dentistry in 2021, 5 years ago. Works from 4 locations. Licensed in New Jersey.

Years since qualifying
5
Trained at
University of Detroit Mercy School of Dentistry
Licensed in
NJ
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

20 Prospect Ave Ste 719
Hackensack, NJ 07601-1974
Phone: (551) 996-5002
Fax: (551) 996-5099
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1441 N 12th St Fl 3, Phoenix, AZ 85006-2837 — (602) 521-5977
  • 102 James St Ste 201, Edison, NJ 08820-3970 — (551) 996-5002
  • 110 Bergen St, Newark, NJ 07103-2495 — (973) 972-4242

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 22DI03073000 (NJ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1164007092
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 11, 2021
Last updated in NPPESMarch 12, 2026
Certification dateMarch 12, 2026
Mailing address1441 N 12th St Fl 3, Phoenix, AZ 85006-2837

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Also practisesMAXILLOFACIAL SURGERY
Medical schoolUNIVERSITY OF DETROIT MERCY SCHOOL OF DENTISTRY
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Hackensack