Active NPI
Daniel Lee, DDS
- General Practice Dentistry
- Odessa, TX
National Provider Identifier
1558774760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 29905
- Practice address
- 1401 E 8TH St
Odessa, TX 79761-4802 - Phone
- (432) 332-8550
- NPI assigned
- Jun 5, 2014
- Last updated
- Jun 5, 2014
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29905 | TX | Primary |
Addresses
Primary practice location
1401 E 8TH St
Odessa, TX 79761-4802
Mailing address
2050 E Algonquin Rd
Ste 610
Schaumburg, IL 60173-4144
Phone (847) 701-1454
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 |
|---|---|---|---|
| 29905 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Odessa PLLC | General Practice | 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, 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": "1401926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401926400000",
"number": "1558774760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 E ALGONQUIN RD",
"address_2": "STE 610",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601734144",
"telephone_number": "847-701-1454",
"fax_number": "847-496-7603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 E 8TH ST",
"city": "ODESSA",
"state": "TX",
"postal_code": "797614802",
"telephone_number": "432-332-8550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DANIEL",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-05",
"last_updated": "2014-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "29905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.