Rebecca Ortenzio Lee, DDS, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0401414723 Issued in VA

Practice address

4600 John Marr Dr Ste 401
Annandale, VA 22003-3310

Phone

(703) 750-9393

NPI assigned

Jan 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Rebecca Marie Ortenzio Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Ellis & Lindgren Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Annandale, VA
  • NPI 1902378557
  NPD (past)
• Ellis Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Annandale, VA
  • NPI 1588144125
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1871563387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 JOHN MARR DR STE 401",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033310",
            "telephone_number": "703-750-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 JOHN MARR DR STE 401",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033310",
            "telephone_number": "703-750-9393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5631 Burke Centre Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Burke",
            "state": "VA",
            "postal_code": "220152234",
            "country_code": "US",
            "telephone_number": "703-750-9393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8998 Lorton Station Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Lorton",
            "state": "VA",
            "postal_code": "220794790",
            "country_code": "US",
            "telephone_number": "703-750-9393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "REBECCA",
        "middle_name": "ORTENZIO",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018139",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "25790",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401414723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "ORTENZIO",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DDS, MSD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hye Sun Lee
• Jongmyeong Lee, MD
• Julia Jiyoung Lee, L.AC
• Kimberly Keomnam Lee, D.D.S.
• Munhyang Lee, M.D.
• Sang Wook Lee, D.D.S
• Sharon Suyon Lee
• Solomon Wansoo Lee
• Tae Yong Lee, DDS
• Young Lee

• Orthodontics and Dentofacial Orthopedics Dentistry in Annandale, VA
• Providers in Annandale, VA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.