Steven B Lee, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12008803 Issued in IN

Practice address

1320 Medical Park Dr
Fort Wayne, IN 46825-5844

Phone

(260) 471-1222

Fax

(260) 471-1724

NPI assigned

Jun 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780880930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MEDICAL PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255844",
            "telephone_number": "260-471-1222",
            "fax_number": "260-471-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MEDICAL PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255844",
            "telephone_number": "260-471-1222",
            "fax_number": "260-471-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "STEVEN",
        "middle_name": "B",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12008803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "000000373783",
            "identifier": "BLUE CROSS BLUE SHIE",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan C Lee, M.D.
• Michael D Lee, MD
• Rebecca L Lee, PHARM.D
• Samuel Lee, DO
• Shuishih Sage Lee
• Vashon Lee, COTA/L
• Rebekah Marie Leemreis, MA, BCBA
• Cassandra Leeper, PHARMD
• Christopher A Leeuw, DPT
• Janet L. Leezer, M.D.

• Periodontics in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Periodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.