Individual provider Active NPI

Lee Byerly

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1972569614
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30017633 Issued in OH
Practice address
7770 Cooper Rd
11
Cincinnati, OH 45242-7744
Phone
(513) 791-1794
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30017633 OH Primary

Addresses

Primary practice location

7770 Cooper Rd
11
Cincinnati, OH 45242-7744

Mailing address

8534 Kelso Dr
Maineville, OH 45039-8837

Other identifiers 1

IdentifierTypeStateIssuer
0566061MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150410000714 OH Order and Referring Only - DentistPractitioner - Dentist 9032437611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30017633OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972569614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8534 KELSO DR",
            "city": "MAINEVILLE",
            "state": "OH",
            "postal_code": "450398837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7770 COOPER RD",
            "address_2": "11",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452427744",
            "telephone_number": "513-791-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYERLY",
        "first_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30017633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0566061",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.