Provider Demographics
NPI:1811999329
Name:LEE, JAMES E (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:LEE
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 1:14748 ROOSEVELT AVE
Mailing Address - Street 2:SUITE # L-6
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4706
Mailing Address - Country:US
Mailing Address - Phone:718-886-9555
Mailing Address - Fax:718-886-9557
Practice Address - Street 1:14748 ROOSEVELT AVE
Practice Address - Street 2:SUITE # L-6
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4706
Practice Address - Country:US
Practice Address - Phone:718-886-9555
Practice Address - Fax:718-886-9557
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049108122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist