Active NPI
Daniel Cooper Lee Jr., DDS
- Prosthodontics
- Davis-Monthan Afb, AZ
National Provider Identifier
1649752841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 0401416188
- Practice address
- 4175 S. Alamo Ave
BLDG 400
Davis-Monthan Afb, AZ 85707 - Phone
- (520) 228-2999
- NPI assigned
- Sep 4, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 0401416188 | VA | Primary |
| General Practice Dentistry | 1223G0001X | 0401416188 | VA |
Addresses
Primary practice location
4175 S. Alamo Ave
BLDG 400
Davis-Monthan Afb, AZ 85707
Mailing address
4175 S Alamo Ave
Davis-Monthan Afb, AZ 85707
Other practice location 1
2355B Faculty Dr
Usafa, CO 80840
Phone (719) 333-5192
Other practice location 2
1100 Wilford Hall Loop
Lackland AFB, TX 78236
Phone (210) 292-4277
Other practice location 3
2133 Pepperrell St
Lackland AFB, TX 78236-5313
Phone (210) 292-0123
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 |
|---|---|---|---|
| 0401416188 | VA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1649752841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4175 S ALAMO AVE",
"city": "DAVIS-MONTHAN AFB",
"state": "AZ",
"postal_code": "85707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4175 S. ALAMO AVE",
"address_2": "BLDG 400",
"city": "DAVIS-MONTHAN AFB",
"state": "AZ",
"postal_code": "85707",
"telephone_number": "520-228-2999"
}
],
"practiceLocations": [
{
"address_1": "2355B Faculty Dr",
"address_purpose": "LOCATION",
"city": "USAFA",
"state": "CO",
"postal_code": "80840",
"country_code": "US",
"telephone_number": "719-333-5192",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 Wilford Hall Loop",
"address_purpose": "LOCATION",
"city": "Lackland AFB",
"state": "TX",
"postal_code": "78236",
"country_code": "US",
"telephone_number": "210-292-4277",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2133 Pepperrell St",
"address_purpose": "LOCATION",
"city": "Lackland AFB",
"state": "TX",
"postal_code": "782365313",
"country_code": "US",
"telephone_number": "210-292-0123",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "DANIEL",
"middle_name": "COOPER",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-04",
"last_updated": "2023-07-24",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "VA",
"license": "0401416188",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401416188",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis-Monthan Afb, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.