Individual provider Active NPI

Paul S Lee, DDS

  • General Practice Dentistry
  • Vestal, NY
National Provider Identifier
1356826374
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060004-1 Issued in NY
Practice address
2521 Vestal Pkwy W
Vestal, NY 13850-1056
Phone
(607) 754-2217
NPI assigned
Sep 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060004-1 NY Primary

Addresses

Primary practice location

2521 Vestal Pkwy W
Vestal, NY 13850-1056

Mailing address

2521 Vestal Pkwy W
Vestal, NY 13850-1056

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
060004-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Paul S. Lee, DDS, PLLC General Practice CurrentSince Mar 12, 2023 Accepting new patients

Locations

555 5th Ave
Brooklyn, NY 11215
Phone (347) 429-8555

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1356826374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 VESTAL PKWY W",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 VESTAL PKWY W",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501056",
            "telephone_number": "607-754-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060004-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.