Active NPI
Brian B Lee, D.M.D.
- Pediatric Dentistry
- Quincy, MA
National Provider Identifier
1497789986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 18806
- Practice address
- 111 Willard St
Suite 2D
Quincy, MA 02169-1200 - Phone
- (617) 471-2184
- Fax
- (617) 471-2185
- NPI assigned
- Jul 10, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 18806 | MA | Primary |
Addresses
Primary practice location
111 Willard St
Suite 2D
Quincy, MA 02169-1200
Mailing address
111 Willard St
Suite 2D
Quincy, MA 02169-1200
Phone (617) 471-2184
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 |
|---|---|---|---|
| 18806 | MA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quincy Pediatric Dental, P.C. | Pediatric Dentistry | Past | Accepting new patients |
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.
-
- Pediatric Dentistry
- Quincy, MA
- NPI 1972533107
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497789986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 WILLARD ST",
"address_2": "SUITE 2D",
"city": "QUINCY",
"state": "MA",
"postal_code": "021691200",
"telephone_number": "617-471-2184",
"fax_number": "617-471-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 WILLARD ST",
"address_2": "SUITE 2D",
"city": "QUINCY",
"state": "MA",
"postal_code": "021691200",
"telephone_number": "617-471-2184",
"fax_number": "617-471-2185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BRIAN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MA",
"license": "18806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.