Provider Demographics
NPI:1932315165
Name:DENNIS H. LEE DDS, PLLC
Entity Type:Organization
Organization Name:DENNIS H. LEE DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-233-4934
Mailing Address - Street 1:217 PARK ROW
Mailing Address - Street 2:SUITE# 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1101
Mailing Address - Country:US
Mailing Address - Phone:212-233-4934
Mailing Address - Fax:212-233-4986
Practice Address - Street 1:217 PARK ROW
Practice Address - Street 2:SUITE# 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1101
Practice Address - Country:US
Practice Address - Phone:212-233-4934
Practice Address - Fax:212-233-4986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0446441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02207683Medicaid
NY02207683Medicaid