Individual provider Active NPI

Samantha Elaine Lee-Chiu, DDS

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1982765590
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00009131 Issued in WA
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

Updated by the provider on Apr 4, 2016

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 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 Other name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401001247 WA Order and Referring Only - DentistPractitioner - Dentist 5890092035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00009131WAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.