Active NPI
Candace Lee, DDS
- Pediatric Dentistry
- New York, NY
National Provider Identifier
1831582147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 058669
- Practice address
- 300 E 23Rd St
Apt PHB
New York, NY 10010-4776 - Phone
- (917) 770-6797
- NPI assigned
- Mar 11, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 058669 | NY | Primary |
Addresses
Primary practice location
300 E 23Rd St
Apt PHB
New York, NY 10010-4776
Mailing address
13620 38TH Ave Ste 8H
Flushing, NY 11354-4232
Phone (917) 770-6797
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058669 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1831582147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13620 38TH AVE STE 8H",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113544232",
"telephone_number": "917-770-6797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E 23RD ST",
"address_2": "APT PHB",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100104776",
"telephone_number": "917-770-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CANDACE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-11",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "058669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.