Kimberly Nicole Lee, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4127-20 Issued in MS

Practice address

105 Broadmoor Dr
Madison, MS 39110-6651

Phone

(601) 856-5227

NPI assigned

Jun 26, 2020

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 names 1

• Kimberly Nicole Morel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1841817657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SILVERLEAF DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391101801",
            "telephone_number": "601-248-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BROADMOOR DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106651",
            "telephone_number": "601-856-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "4127-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MOREL",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Leah Williamson Counseling Services LLC
• Olivia Leber, PMHNP
• Taylor Crawford Lee, MOT
• Molly Dallas Lemoine, FNP-C
• Marjorie Lenoir, OD
• Carmen Marie Lewis, PHARMD
• Emily Liddon, OTR

• General Practice Dentistry in Madison, MS
• Providers in Madison, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.