Active NPI
Charles Lee, DDS
- Endodontics
- Independence, MO
National Provider Identifier
1982624995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 15489
- Practice address
- 19401 E US Highway 40
Suite 180
Independence, MO 64055-5450 - Phone
- (816) 795-7007
- Fax
- (816) 795-7073
- NPI assigned
- Jul 20, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 15489 | MO | Primary |
Addresses
Primary practice location
19401 E US Highway 40
Suite 180
Independence, MO 64055-5450
Mailing address
19401 E US Highway 40
Suite 180
Independence, MO 64055-5450
Phone (816) 795-7007
Other names 1
- Dr. Qiao Li
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 |
|---|---|---|---|
| 15489 | MO | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louis L. Loos, DDS, PC | Past | Accepting new patients | |
| Eastland Family Dental, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Independence, MO
- NPI 1730401738
-
- General Practice Dentistry
- Independence, MO
- NPI 1073550414
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982624995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19401 E US HIGHWAY 40",
"address_2": "SUITE 180",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640555450",
"telephone_number": "816-795-7007",
"fax_number": "816-795-7073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19401 E US HIGHWAY 40",
"address_2": "SUITE 180",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640555450",
"telephone_number": "816-795-7007",
"fax_number": "816-795-7073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CHARLES",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MO",
"license": "15489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "QIAO",
"last_name": "LI",
"prefix": "DR.",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.