Lee Warren Dekrey, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D13401 Issued in MN

Practice address

3359 W Broadway Ave
Robbinsdale, MN 55422-2928

Phone

(763) 270-5776

Fax

(763) 201-7326

NPI assigned

Jun 12, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1659785269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 W BROADWAY AVE",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222928",
            "telephone_number": "763-270-5776",
            "fax_number": "763-201-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3359 W BROADWAY AVE",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222928",
            "telephone_number": "763-270-5776",
            "fax_number": "763-201-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEKREY",
        "first_name": "LEE",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela G Dean, RN, CNP
• Stefan L Deboel, MD
• Ashley Marie Deckman, CGC
• Jessica Deforrest, MA, ATC
• Jennifer Mina Deisler, APRN, CNP
• Bradly Delong, LPCC
• Nicole Des Marais
• Guy Deutschman, RRT
• Thomas Michael Dewerd, DDS
• Deanna Jo Diebold, M.D.

• Dentist in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.

Verify at the official NPI Registry.