Mary Dickerson Lee, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

LNO4503 Issued in AL

Practice address

1303 Dr Martin L King Jr Ave
Franklin Primary Health Center Inc
Mobile, AL 36603-5341

Phone

(251) 432-4117

Fax

(251) 964-4011

NPI assigned

Mar 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Interoperability endpoints

• Direct secure messaging: mdickersonlee374708@direct.ochin.org

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.

• Franklin Primary Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Frisco City, AL
  • NPI 1982024402
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1356301659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2048",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522048",
            "telephone_number": "251-432-4117",
            "fax_number": "251-964-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 DR MARTIN L KING JR AVE",
            "address_2": "FRANKLIN PRIMARY HEALTH CENTER INC",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035341",
            "telephone_number": "251-432-4117",
            "fax_number": "251-964-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON LEE",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "LNO4503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51092208",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diabetic Supplies Depot
• Diagnostic & Medical Oncology PC
• Diagnostic Physicians Group, P.C.
• Charles Robert Diard, MD
• Carlos M Diaz, MD
• Andrew Cory Dickinson, RN
• Angelia Bessie Dickinson, MS, ALC
• Hazel Dickinson, NP
• Christina Leigh Dickson, LBSW
• Hunter Chance Dickson, D.O.

• Dentist in Mobile, AL
• Providers in Mobile, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.