Individual provider Active NPI

Jeffrey Lee, DDS

  • General Practice Dentistry
  • Burien, WA
National Provider Identifier
1023068301
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9253 Issued in WA
Practice address
14212 Ambaum Blvd SW
Ste #203
Burien, WA 98166-1449
Phone
(206) 242-2466
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9253 WA Primary

Addresses

Primary practice location

14212 Ambaum Blvd SW
Ste #203
Burien, WA 98166-1449

Mailing address

1420 Terry Ave
Apt 2503
Seattle, WA 98101-1979
Phone (206) 388-4079

Other identifiers 1

IdentifierTypeStateIssuer
5048194MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9253WAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023068301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 TERRY AVE",
            "address_2": "APT 2503",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011979",
            "telephone_number": "206-388-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW",
            "address_2": "STE #203",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661449",
            "telephone_number": "206-242-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5048194",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.