William J Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

012524 Issued in MI

Practice address

2605 N West Bay Shore Dr
Peshawbestown, MI 49682-9275

Phone

(231) 534-7212

NPI assigned

Aug 3, 2006

Last updated

Jul 24, 2012By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

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.

• Grand Traverse Band of Ottawa and Chippewa Indians

  dba Grand Traverse Band Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Suttons Bay, MI
  • NPI 1134281132
  NPD (past)
• Grand Traverse Band of Ottawa and Chippewa Indians

  • Psychiatric/Mental Health Registered Nurse
  • Peshawbestown, MI
  • NPI 1477227239
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1679581177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N WEST BAY SHORE DR",
            "city": "PESHAWBESTOWN",
            "state": "MI",
            "postal_code": "496829275",
            "telephone_number": "231-534-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 N WEST BAY SHORE DR",
            "city": "PESHAWBESTOWN",
            "state": "MI",
            "postal_code": "496829275",
            "telephone_number": "231-534-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "012524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Traverse Band of Ottawa and Chippewa Indians
• Samantha J Haken, MD
• Sandra Leanne Handysides, RN, FNP
• Kristen M Holston, RDH
• Denise Johnson
• Emily Marie Schmitt, DNP
• Marion I Wabanimkee-Minzey

• Dentist in Peshawbestown, MI
• Providers in Peshawbestown, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.