Active NPI
Mitchell Lee
- Dentist
- Phoenix, AZ
National Provider Identifier
1295466753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D011423
- Practice address
- 3101 W Indian School Rd
Phoenix, AZ 85017-4035 - Phone
- (602) 861-3333
- Fax
- (602) 682-7733
- NPI assigned
- Jun 23, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D011423 | AZ | Primary |
Addresses
Primary practice location
3101 W Indian School Rd
Phoenix, AZ 85017-4035
Mailing address
3101 W Indian School Rd
Phoenix, AZ 85017-4035
Phone (602) 861-3333
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 6028613333 | Direct |
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 |
|---|---|---|---|
| D011423 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivy 2 Dental PLLC | Past | Accepting new patients | |
| Cute Smiles 4 Kids | Past | Accepting new patients | |
| Sdcaz LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- General Practice Dentistry
- Phoenix, AZ
- NPI 1538314992
-
- Pediatric Dentistry
- Avondale, AZ
- NPI 1689100885
-
- Pediatric Dentistry
- Phoenix, AZ
- NPI 1659175347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655942400000",
"number": "1295466753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 W INDIAN SCHOOL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850174035",
"telephone_number": "602-861-3333",
"fax_number": "602-682-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 W INDIAN SCHOOL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850174035",
"telephone_number": "602-861-3333",
"fax_number": "602-682-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MITCHELL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-23",
"last_updated": "2022-06-23",
"certification_date": "2022-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D011423",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "6028613333",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3101 W Indian School Rd",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850174035",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.