Active NPI
Samantha Elaine Lee-Chiu, DDS
- General Practice Dentistry
- Seattle, WA
National Provider Identifier
1982765590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00009131
- Practice address
- 1629 N 45TH St
Seattle, WA 98103-6701 - Phone
- (206) 548-3114
- Fax
- (206) 762-6355
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 | DE00009131 | WA | Primary |
Addresses
Primary practice location
1629 N 45TH St
Seattle, WA 98103-6701
Mailing address
1200 12TH Ave S
Suite 901
Seattle, WA 98144-2712
Phone (206) 548-3114
Other names 1
- Samantha Elaine Lee
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- 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 |
|---|---|---|---|---|
| I20160401001247 | WA | Order and Referring Only - Dentist | 5890092035 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00009131 | WA | MD | General Practice Dentistry |
Interoperability endpoints
- sleechiu1174161@wm.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459728000000",
"number": "1982765590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 12TH AVE S",
"address_2": "SUITE 901",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981442712",
"telephone_number": "206-548-3114",
"fax_number": "206-762-6355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1629 N 45TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981036701",
"telephone_number": "206-548-3114",
"fax_number": "206-762-6355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE-CHIU",
"first_name": "SAMANTHA",
"middle_name": "ELAINE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2016-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00009131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "LEE",
"middle_name": "ELAINE",
"credential": "DDS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.