NPIMap

Individual provider Active NPI

Shandra C Lee, DMD

  • Endodontics
  • Mount Vernon, WA
National Provider Identifier
1497729487
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DE6096513 Issued in WA
Practice address
130 S 15TH St Ste 101
Mount Vernon, WA 98274-4569
Phone
(360) 428-4393
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DE6096513 WA Primary

Addresses

Primary practice location

130 S 15TH St Ste 101
Mount Vernon, WA 98274-4569

Mailing address

4580 Lost Creek LN
Bellingham, WA 98229-2576
Phone (480) 458-7968

Other practice location 1

1310 Broadway Ste 1B
Bellingham, WA 98225-2953
Phone (360) 734-4777

Other names 1

  • Dr. Shandra C Lee Other name

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
DE6096513WAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Shandra Lee DMD PLLC Endodontics Current Accepting new patients
Matthew Eric Carlson, DDS, PLLC Endodontics PastSince Feb 8, 2023 Accepting new patients
Norterra Dental Group and Orthodontics, LLP PastSince Dec 1, 2020 Accepting new patients
Precision Endodontics LLC Endodontics Past Accepting new patients

Locations

130 S 15th St
Ste 101
Mount Vernon, WA 98274
Phone (360) 428-4393

Organizations & group practices 4

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1497729487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 LOST CREEK LN",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982292576",
            "telephone_number": "480-458-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S 15TH ST STE 101",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744569",
            "telephone_number": "360-428-4393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Broadway Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982252953",
            "country_code": "US",
            "telephone_number": "360-734-4777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SHANDRA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE6096513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANDRA",
            "last_name": "LEE",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "D.M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.