Active NPI
Henry Youchee Lee, D.D.S.
- Dentist
- Olney, MD
National Provider Identifier
1063441707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6994
- Practice address
- 17721 Georgia Ave
Olney, MD 20832-2231 - Phone
- (301) 774-2474
- Fax
- (301) 570-4017
- NPI assigned
- Jul 3, 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 | 6994 | MD | Primary |
Addresses
Primary practice location
17721 Georgia Ave
Olney, MD 20832-2231
Mailing address
PO Box 569
17721 Georgia Avenue
Olney, MD 20830-0569
Phone (301) 774-2474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- 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 |
|---|---|---|---|---|
| I20160426000648 | MD | Order and Referring Only - Dentist | 4789983784 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6994 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063441707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 569",
"address_2": "17721 GEORGIA AVENUE",
"city": "OLNEY",
"state": "MD",
"postal_code": "208300569",
"telephone_number": "301-774-2474",
"fax_number": "301-570-4017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17721 GEORGIA AVE",
"city": "OLNEY",
"state": "MD",
"postal_code": "208322231",
"telephone_number": "301-774-2474",
"fax_number": "301-570-4017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "HENRY",
"middle_name": "YOUCHEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "6994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olney, MD
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.