Individual provider Active NPI

Eugene Lee

  • Dentist
  • Lake City, FL
National Provider Identifier
1083275648
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN24297 Issued in FL
Practice address
2970 W US Highway 90
Lake City, FL 32055-4700
Phone
(386) 438-5766
NPI assigned
Jun 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24297 FL Primary

Addresses

Primary practice location

2970 W US Highway 90
Lake City, FL 32055-4700

Mailing address

2970 W US Highway 90
Lake City, FL 32055-4700
Phone (386) 438-5766

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
DN24297FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1083275648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 W US HIGHWAY 90",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554700",
            "telephone_number": "386-438-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 W US HIGHWAY 90",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554700",
            "telephone_number": "386-438-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUGENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.