Bobby S. Lee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02426300 Issued in NJ

Practice address

170 Changebridge Rd Ste C-1
Montville, NJ 07045-9115

Phone

(973) 227-7110

Fax

(973) 227-7118

NPI assigned

Jun 13, 2010

Sex

Male

Sole proprietor

Yes

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 NJ

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": "1276387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1811218928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 CHANGEBRIDGE RD STE C-1",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459115",
            "telephone_number": "973-227-7110",
            "fax_number": "973-227-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 CHANGEBRIDGE RD STE C-1",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459115",
            "telephone_number": "973-227-7110",
            "fax_number": "973-227-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BOBBY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-13",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02426300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rena L Kreitman
• Laura Kuskin, PT, DPT
• Lisa Labrunda, LCSW
• Pareen Raj Lapsiwala, D.O.
• Karen Lassoni, DPT
• Janice Y Lee, D.D.S.
• Cary Howard Leizer, D.M.D.
• Levinson Eye Care Center
• Levinson Eye Care Center LLC
• Howard B Levinson, O.D

• General Practice Dentistry in Montville, NJ
• Providers in Montville, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.