Kenneth Lee

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.033918 Issued in IL

Practice address

3210 W 63Rd St
Chicago, IL 60629-3325

Phone

(773) 776-8300

NPI assigned

Jul 5, 2022

Last updated

Aug 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Experts, LLC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1346411337
  NPD (past)
• The Dental Clinic, LLC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1538330527
  NPD (past)

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1255064614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BAY CLUB DR APT 16K",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602930",
            "telephone_number": "347-551-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606293325",
            "telephone_number": "773-776-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3057 W Cermak Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606233548",
            "country_code": "US",
            "telephone_number": "773-257-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENNETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033918",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Lee
• Katrina Lee
• Kelly Lee, PHARMD
• Kelly Marie Lee, C.P.
• Kelsey Lee
• Kenneth Lee
• Kenneth Lee
• Kenneth Y Lee, MD
• Kew-Jung Lee, M.D.
• Kristen Ann Lee, MD

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.