Dianne Lee

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02828300 Issued in NJ

Practice address

11 Kiel Ave
Kinnelon, NJ 07405-2549

Phone

(973) 838-7888

NPI assigned

Jul 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• DS Dental Arts

  • Pediatric Dentistry
  • Cliffside Park, NJ
  • NPI 1982856357
  NPD (past)

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1194342386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 VINCENT WAY",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194012058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 KIEL AVE",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074052549",
            "telephone_number": "973-838-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Main St",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "NJ",
            "postal_code": "076441767",
            "country_code": "US",
            "telephone_number": "201-397-1420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "634 Anderson Ave",
            "address_purpose": "LOCATION",
            "city": "Cliffside Park",
            "state": "NJ",
            "postal_code": "070101811",
            "country_code": "US",
            "telephone_number": "201-945-1119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "DIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-03",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS042676",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042676",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02828300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Kunkis, MD, MBA
• Angela Kuzmanoski, PHARMD
• Monica Joanna Largo, PHARMD
• Morgan Duda Larson, LMT
• Paul Thomas Leary, DMD
• Jenna Yeonkyung Lee, DMD
• Leland Newman, LCSW
• Allison Theresa Leshik
• Barry E. Levant, MD
• Jessica Lee Logan, D.M.D.

• Pediatric Dentistry in Kinnelon, NJ
• Providers in Kinnelon, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.

Verify at the official NPI Registry.