Individual provider Active NPI

Clara Lee, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1447249792
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046522 Issued in NY
Practice address
10 Waterside PLZ
Lobby Level
New York, NY 10010-2602
Phone
(212) 683-6260
Fax
(212) 686-0460
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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 046522 NY Primary

Addresses

Primary practice location

10 Waterside PLZ
Lobby Level
New York, NY 10010-2602

Mailing address

10 Waterside PLZ
Lobby Level
New York, NY 10010-2602
Phone (212) 683-6260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160105002112 NY Order and Referring Only - DentistPractitioner - Dentist 0749582955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046522NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1447249792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WATERSIDE PLZ",
            "address_2": "LOBBY LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102602",
            "telephone_number": "212-683-6260",
            "fax_number": "212-686-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WATERSIDE PLZ",
            "address_2": "LOBBY LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102602",
            "telephone_number": "212-683-6260",
            "fax_number": "212-686-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CLARA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.