Active NPI
Donald Ray Lee, DDS
- Dentist
- Worthington, OH
National Provider Identifier
1023198850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30014112
- Practice address
- 6797 N High St
Suite 211
Worthington, OH 43085-2533 - Phone
- (614) 547-0001
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30014112 | OH | Primary |
Addresses
Primary practice location
6797 N High St
Suite 211
Worthington, OH 43085-2533
Mailing address
6797 N High St
Suite 211
Worthington, OH 43085-2533
Phone (614) 547-0001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0264075 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161201002366 | OH | Order and Referring Only - Dentist | 3476833757 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30014112 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1023198850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6797 N HIGH ST",
"address_2": "SUITE 211",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430852533",
"telephone_number": "614-547-0001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6797 N HIGH ST",
"address_2": "SUITE 211",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430852533",
"telephone_number": "614-547-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DONALD",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30014112",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0264075",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worthington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.