Provider Demographics
NPI:1437186384
Name:LEE, DENNIS DON (MD MPH)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:DON
Last Name:LEE
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:DENNIS
Other - Middle Name:D
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD MPH
Mailing Address - Street 1:135 PUUHONU WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-935-4444
Mailing Address - Fax:808-935-7720
Practice Address - Street 1:135 PUUHONU WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-935-4444
Practice Address - Fax:808-935-7720
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD52672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01973301Medicaid
HI01973301Medicaid
HIH0000BDNCJMedicare PIN
D36364Medicare UPIN