Active NPI
Stewart R Lee, D.D.S.
- Dentist
- Los Angeles, CA
National Provider Identifier
1104917293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33614
- Practice address
- 1530 S Olive St
Los Angeles, CA 90015-3023 - Phone
- (213) 746-1037
- Fax
- (213) 746-9379
- NPI assigned
- Sep 27, 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 | 33614 | CA | Primary |
Addresses
Primary practice location
1530 S Olive St
Los Angeles, CA 90015-3023
Mailing address
1530 S Olive St
Los Angeles, CA 90015-3023
Phone (213) 746-1037
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | stewart.lee.p1@direct.eisnerhealth.nextgenshare.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|---|
| I20220804001416 | CA | Order and Referring Only - Dentist | 9436531613 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33614 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1104917293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 S OLIVE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900153023",
"telephone_number": "213-746-1037",
"fax_number": "213-746-9379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 S OLIVE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900153023",
"telephone_number": "213-746-1037",
"fax_number": "213-746-9379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "STEWART",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "33614",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "stewart.lee.p1@direct.eisnerhealth.nextgenshare.com",
"affiliation": "N",
"endpointDescription": "NextGenShare, Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1530 S Olive St",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900153023",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.