Rollyn Paul Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4876015 Issued in WI

Practice address

1030 River Place Drive
106
Amery, WI 54001-0106

Phone

(715) 268-2103

Fax

(715) 268-7729

NPI assigned

Jul 28, 2006

Last updated

Jun 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• River Place Dental, Inc

  • Dental Clinic/Center
  • Amery, WI
  • NPI 1215177555
  NPD (past) Authorized official
• Marks Dental Corporation, S.C.

  dba River Place Dental

  • Dentist
  • Amery, WI
  • NPI 1881303360
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1649284134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 106",
            "address_2": "1030 RIVER PLACE DRIVE",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "54001",
            "telephone_number": "715-268-2103",
            "fax_number": "715-268-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 RIVER PLACE DRIVE",
            "address_2": "106",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540010106",
            "telephone_number": "715-268-2103",
            "fax_number": "715-268-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROLLYN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4876015",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D9794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristo LTD (Kristo Orthodontics)
• Jill R. Ladwig, PTA
• James J Lampi, D.D.S.
• Brian D. Lease, PT
• Kailey M Ledo, PA
• Elizabeth E Leonard, P.T.
• Joann Cecilia Keith Litkey, MD
• Jeffrey Coleman Lund
• Deborah F. Manni, O.T.
• Marks Dental Corporation, S.C. (River Place Dental)

• Dentist in Amery, WI
• Providers in Amery, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.

Verify at the official NPI Registry.