Kenneth Lee, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401411627 Issued in VA

Practice address

7574 Telegraph Rd
Alexandria, VA 22315-3829

Phone

(703) 971-2220

NPI assigned

Jul 31, 2007

Last updated

Apr 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Practice roles

Locations

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.

• Hayfield Dental Specialists PLLC

  dba Charles H. Brown III Sole MBR

  • Periodontics
  • Alexandria, VA
  • NPI 1578288148
  NPD
• Charles H Brown III DDS PC

  dba Hayfield Dental Care Kingstowne Orthodontics

  • General Practice Dentistry
  • Alexandria, VA
  • NPI 1912000415
  NPD (past)
• Sanginiti Dentistry LLC

  dba Glen Park Family Dentistry

  • General Practice Dentistry
  • Glen Burnie, MD
  • NPI 1013529825
  NPD (past)

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1821288317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6289 FAIRFAX NATIONAL WAY",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7574 TELEGRAPH RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223153829",
            "telephone_number": "703-971-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411627",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Lee, OTR/L
• Jong K Lee, M.D.
• Josephine Lee
• June Jieun Lee, FNP-C
• Jung Lee, OD
• Kristopher Lee
• Lesley H Lee, M.D.
• Richard Lee, D.P.M.
• Sau Fan William Jr Lee
• Serita Lee

• Dentist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.