Active NPI
John S Lee, DMD, MS
- Endodontics
- Coppell, TX
National Provider Identifier
1164417267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 23777
- Practice address
- 600 S Denton Tap Rd Ste 200
Coppell, TX 75019-4539 - Phone
- (972) 471-0647
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901019436 | MI | |
| General Practice Dentistry | 1223G0001X | 22DI02264400 | NJ | |
| General Practice Dentistry | 1223G0001X | DS035851 | PA | |
| Endodontics | 1223E0200X | 23777 | TX | Primary |
Addresses
Primary practice location
600 S Denton Tap Rd Ste 200
Coppell, TX 75019-4539
Mailing address
600 S Denton Tap Rd Ste 200
Coppell, TX 75019-4539
Phone (972) 471-0647
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901019436 | MI | MD | General Practice Dentistry |
| 22DI02264400 | NJ | MD | General Practice Dentistry |
| DS035851 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241395200000",
"number": "1164417267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S DENTON TAP RD STE 200",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194539",
"telephone_number": "972-471-0647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S DENTON TAP RD STE 200",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194539",
"telephone_number": "972-471-0647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOHN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2009-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901019436",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02264400",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS035851",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "23777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.