Individual provider Active NPI

Kerry Hope O'Bannon Lee, DDS

  • Pediatric Dentistry
  • Wenatchee, WA
National Provider Identifier
1255031019
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE.61459409 Issued in WA
Practice address
146 Easy Way
Wenatchee, WA 98801-8108
Phone
(509) 664-5000
NPI assigned
Mar 9, 2023
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DE.61459409 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X WA

Addresses

Primary practice location

146 Easy Way
Wenatchee, WA 98801-8108

Mailing address

190 Adel LN
Wenatchee, WA 98801-5811
Phone (703) 606-1879

Other names 1

  • Kerry Hope O'Bannon Former name

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
DE.61459409WAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1255031019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 ADEL LN",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988015811",
            "telephone_number": "703-606-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 EASY WAY",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988018108",
            "telephone_number": "509-664-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KERRY",
        "middle_name": "HOPE O'BANNON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE.61459409",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "O'BANNON",
            "middle_name": "HOPE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.