Susan Lee, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

009701 Issued in CT

Practice address

323 Main St
West Haven, CT 06516-4424

Phone

(203) 937-7181

Fax

(203) 937-1940

NPI assigned

Jun 11, 2007

Sex

Female

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 CT

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

Practice roles

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.

• Connecticut Oral & Maxillofacial Surgery Centers, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Meriden, CT
  • NPI 1083818710
  Medicare reassignment NPD

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1780887281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MAIN STREET",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161638",
            "telephone_number": "203-937-7181",
            "fax_number": "203-937-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164424",
            "telephone_number": "203-937-7181",
            "fax_number": "203-937-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "009701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002457",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Leckie
• Jennifer Lee, PHARMD
• Ocean Lee
• Sinsook E Lee, PHARMD
• Soolim Lee
• Tamar Kim Lee, M.S., CCC
• Ira Lewis Leeds
• Hannah C Leiterman, M.A., L.C.S.W.
• Steven Lemieux
• Michelle D. Leon, MD

• Oral and Maxillofacial Surgery (Dentist) in West Haven, CT
• Providers in West Haven, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.