Provider Demographics
NPI:1902834302
Name:LEE, DANIEL HARVEY (DDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HARVEY
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4132 S RAINBOW BLVD STE 286
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3106
Mailing Address - Country:US
Mailing Address - Phone:949-283-2763
Mailing Address - Fax:
Practice Address - Street 1:4132 S RAINBOW BLVD STE 286
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3106
Practice Address - Country:US
Practice Address - Phone:949-283-2763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA568611223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA02779019Medicaid
NY201756342OtherPEDIATRIC DENTIST