Individual provider Active NPI

James Lee, BDS HONS

  • Prosthodontics
  • Edina, MN
National Provider Identifier
1528443751
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
S156 Issued in MN
Practice address
6545 France Ave S Ste 680
Edina, MN 55435-2127
Phone
(952) 922-5326
NPI assigned
Jul 29, 2015
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X R635 MN
Prosthodontics 1223P0700X S156 MN Primary

Addresses

Primary practice location

6545 France Ave S Ste 680
Edina, MN 55435-2127

Mailing address

616 Washington Ave SE
Apartment 619a
Minneapolis, MN 55414-2996
Phone (612) 814-2704

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
R635MNMDProsthodontist
S156MNMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Reconstructive Dentistry PLLC Prosthodontics CurrentSince Mar 26, 2023 Accepting new patients

Locations

6545 France Ave S
Ste 680
Edina, MN 55435
Phone (952) 920-7482

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1528443751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 WASHINGTON AVE SE",
            "address_2": "APARTMENT 619A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142996",
            "telephone_number": "612-814-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S STE 680",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352127",
            "telephone_number": "952-922-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAMES",
        "credential": "BDS HONS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "R635",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "S156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.