Active NPI
Teresa J. Lee, D.D,S.
- Pediatric Dentistry
- Merced, CA
National Provider Identifier
1073743944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 56271
- Practice address
- 3351 M St Ste 115
Merced, CA 95348-2732 - Phone
- (209) 383-7804
- Fax
- (209) 383-9154
- NPI assigned
- Jul 24, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 56271 | CA | Primary |
Addresses
Primary practice location
3351 M St Ste 115
Merced, CA 95348-2732
Mailing address
3351 M St Ste 115
Merced, CA 95348-2732
Phone (209) 383-7804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20150812006367 | CA | Order and Referring Only - Dentist | 6305151945 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306281600000",
"number": "1073743944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3351 M ST STE 115",
"city": "MERCED",
"state": "CA",
"postal_code": "953482732",
"telephone_number": "209-383-7804",
"fax_number": "209-383-9154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3351 M ST STE 115",
"city": "MERCED",
"state": "CA",
"postal_code": "953482732",
"telephone_number": "209-383-7804",
"fax_number": "209-383-9154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "TERESA",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.D,S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-24",
"last_updated": "2011-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "56271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merced, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.