Active NPI
Shawn D Lee, D.M.D.
- General Practice Dentistry
- Nampa, ID
National Provider Identifier
1962714139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-4303
- Practice address
- 2811 12TH Ave Rd
Nampa, ID 83686-8482 - Phone
- (208) 466-2458
- NPI assigned
- Jul 5, 2010
- Sex
- Male
- 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 | D-4303 | ID | Primary |
Addresses
Primary practice location
2811 12TH Ave Rd
Nampa, ID 83686-8482
Mailing address
5398 N Lange Ave
Meridian, ID 83646-6228
Phone (208) 371-5132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4303 | ID | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shawn Lee DMD LLC | Past | Accepting new patients |
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": "1278288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278288000000",
"number": "1962714139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5398 N LANGE AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836466228",
"telephone_number": "208-371-5132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2811 12TH AVE RD",
"city": "NAMPA",
"state": "ID",
"postal_code": "836868482",
"telephone_number": "208-466-2458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SHAWN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-05",
"last_updated": "2010-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-4303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.