Active NPI
Sodam Lee, DMD
- Endodontics
- Dallas, TX
National Provider Identifier
1164717674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 37906
- Practice address
- 6243 Retail Rd Ste 100
Dallas, TX 75231-7845 - Phone
- (214) 757-4500
- NPI assigned
- Jun 13, 2011
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 37906 | TX | Primary |
Addresses
Primary practice location
6243 Retail Rd Ste 100
Dallas, TX 75231-7845
Mailing address
6243 Retail Rd Ste 100
Dallas, TX 75231-7845
Phone (214) 757-4500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 37906 | TX | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Workshop Timber Creek, PLLC | Current | Accepting new patients |
Locations
6243 Retail Rd
Ste 100
Dallas, TX 75231
Phone (214) 368-3384
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642032000000",
"number": "1164717674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6243 RETAIL RD STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752317845",
"telephone_number": "214-757-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6243 RETAIL RD STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752317845",
"telephone_number": "214-757-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SODAM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-13",
"last_updated": "2022-01-13",
"certification_date": "2022-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "37906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.