Timothy D. Lee, DDS, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22042 Issued in TX

Legal business name

TIMOTHY D. LEE, DDS, PC

Doing business as

Children's Dentistry of Wichita Falls

Practice address

4021 Rhea Rd
Wichita Falls, TX 76308-2727

Phone

(940) 613-0210

Fax

(940) 613-0213

NPI assigned

Mar 4, 2010

Last updated

Mar 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Dae Lee, D.D.S.NPI 1982638359

Title

President

Phone

(214) 923-0648

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Children's Dentistry of Wichita Falls Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Dae Lee, DDS

  • Pediatric Dentistry
  • Wichita Falls, TX
  • NPI 1982638359
  NPD (past) Authorized official

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1962725994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 RHEA RD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082727",
            "telephone_number": "940-613-0210",
            "fax_number": "940-613-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 RHEA RD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082727",
            "telephone_number": "940-613-0210",
            "fax_number": "940-613-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY D. LEE, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "DAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-923-0648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "22042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209326201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3469330-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dentistry of Wichita Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Thueson, M.D.
• Sirisha Thummalapenta
• Randy N Thurmond II
• William Lewis Tidmore, M.D.
• Alexa M Tidwell, RBT
• Brigette Sharie Tisdale, REGISTERED PHARMACIS
• Taylor Franklin Tisdale, DO
• Titanium Emergency Group LLP
• Tmho LLC Texasmentalhealthonline
• Callie Renae Todd, MD

• Pediatric Dentistry in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.