Active NPI
Carol Lee, DMD
- General Practice Dentistry
- Sacramento, CA
National Provider Identifier
1952132938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 110528
- Practice address
- 3701 J St Ste 201
Sacramento, CA 95816 - Phone
- (916) 454-2345
- NPI assigned
- Aug 12, 2024
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 110528 | CA | Primary |
Addresses
Primary practice location
3701 J St Ste 201
Sacramento, CA 95816
Mailing address
1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240918000644 | CA | Order and Referring Only - Dentist | 6507307501 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110528 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1952132938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 HOWE AVE STE 440",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958251098",
"telephone_number": "916-569-8484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 J ST STE 201",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95816",
"telephone_number": "916-454-2345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CAROL",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-12",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "110528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.