Provider Demographics
NPI:1588676563
Name:WEINSTEIN, LEE T (DDS)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:T
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E LITTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-2603
Mailing Address - Country:US
Mailing Address - Phone:757-962-6769
Mailing Address - Fax:757-410-2658
Practice Address - Street 1:300 E LITTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-2603
Practice Address - Country:US
Practice Address - Phone:757-962-6769
Practice Address - Fax:757-410-2658
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007794122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist