Active NPI
James Emmanuel Lee, DMD
- Dentist
- Malden, MA
National Provider Identifier
1619384393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1856629
- Practice address
- 572 Pleasant St
Malden, MA 02148-3550 - Phone
- (781) 397-8876
- Fax
- (781) 324-7166
- NPI assigned
- Jul 15, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 1856629 | MA | Primary |
Addresses
Primary practice location
572 Pleasant St
Malden, MA 02148-3550
Mailing address
572 Pleasant St
Malden, MA 02148-3550
Phone (781) 397-8876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160112002509 | MA | Order and Referring Only - Dentist | 6305148073 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1856629 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston Family Dental LLC | 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.
-
- General Practice Dentistry
- Malden, MA
- NPI 1801962618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405382400000",
"number": "1619384393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "572 PLEASANT ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021483550",
"telephone_number": "781-397-8876",
"fax_number": "781-324-7166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "572 PLEASANT ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021483550",
"telephone_number": "781-397-8876",
"fax_number": "781-324-7166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JAMES",
"middle_name": "EMMANUEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-15",
"last_updated": "2014-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "1856629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.