Individual provider Active NPI

Daniel Lee, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Dallas, TX
National Provider Identifier
1710436886
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
32119 Issued in TX
Practice address
6243 Retail Rd Ste 100
Dallas, TX 75231-7845
Phone
(214) 368-3384
NPI assigned
Sep 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 32119 TX Primary

Addresses

Primary practice location

6243 Retail Rd Ste 100
Dallas, TX 75231-7845

Mailing address

924 Milwaukee Ave Apt 2406
Lubbock, TX 79416-5987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20230714000797 TX Order and Referring Only - DentistPractitioner - Dentist 5597125120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Workshop Timber Creek, PLLC Dentist CurrentSince May 28, 2023 Accepting new patients

Locations

6243 Retail Rd
Ste 100
Dallas, TX 75231
Phone (214) 368-3384

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.

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1710436886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 MILWAUKEE AVE APT 2406",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794165987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6243 RETAIL RD STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752317845",
            "telephone_number": "214-368-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DANIEL",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "32119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.