Jeffrey Scott Lee, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60751453 Issued in WA

Practice address

605 S Coolidge St
Moses Lake, WA 98837-1893

Phone

(509) 765-0674

Fax

(509) 765-0674

NPI assigned

Jun 15, 2015

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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 TN

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Dental Associates, PLLC

  • General Practice Dentistry
  • Oak Ridge, TN
  • NPI 1477687457
  NPD (past)

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952782088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-765-0674",
            "fax_number": "509-764-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-765-0674",
            "fax_number": "509-765-0674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Laboratory Rd",
            "address_2": "107",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306810",
            "country_code": "US",
            "telephone_number": "865-483-1323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10104",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60751453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marielle Chloe Aline Larsen, PA-C
• Michelle Laska, BSS
• Gabriel Carver Lautenschlager, PHARM. D.
• Giao Quynh Le, M.D.
• Jaeyeon Lee
• Corey Levi, LMT
• Christiian T Lewis, ARNP
• Erin K Lewis, PT
• Ioly Tabita Lewis, PMHNP/ARNP
• Liberty Enterprises, LLC

• Dentist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.