Individual provider Active NPI

Kendrick Lee, DMD, MS

  • Dentist
  • Federalsburg, MD
National Provider Identifier
1962244699
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18989 Issued in MD
Practice address
320 Hargraves Dr
Federalsburg, MD 21632-1088
Phone
(410) 754-9021
NPI assigned
Jun 12, 2024
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18989 MD Primary
Dentist 122300000X D.007330-C1 AL

Addresses

Primary practice location

320 Hargraves Dr
Federalsburg, MD 21632-1088

Mailing address

320 Hargraves Dr
Federalsburg, MD 21632-1088
Phone (410) 754-9021

Other practice location 1

1700 6th Ave N
Bessemer, AL 35020-4849
Phone (205) 434-2031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20250920000371 MD Order and Referring Only - DentistPractitioner - Dentist 0749784817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D.007330-C1ALMDDentist
18989MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Dental Mobile LLC Dentist CurrentSince Jun 1, 2024 Accepting new patients

Locations

1700 6th Ave N
Bessemer, AL 35020
Phone (205) 423-2031

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1962244699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HARGRAVES DR",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "216321088",
            "telephone_number": "410-754-9021",
            "fax_number": "833-916-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 HARGRAVES DR",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "216321088",
            "telephone_number": "410-754-9021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 6th Ave N",
            "address_purpose": "LOCATION",
            "city": "Bessemer",
            "state": "AL",
            "postal_code": "350204849",
            "country_code": "US",
            "telephone_number": "205-434-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENDRICK",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-12",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "18989",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D.007330-C1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federalsburg, MD

Sources for this page

Verify at the official NPI Registry.