Active NPI
Kendrick Lee, DMD, MS
- Dentist
- Federalsburg, MD
National Provider Identifier
1962244699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 18989
- Practice address
- 320 Hargraves Dr
Federalsburg, MD 21632-1088 - Phone
- (410) 754-9021
- NPI assigned
- Jun 12, 2024
- Last updated
- Sep 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250920000371 | MD | Order and Referring Only - Dentist | 0749784817 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D.007330-C1 | AL | MD | Dentist |
| 18989 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mission Dental Mobile LLC | Dentist | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.