BRENT D LEE (NPI# 1154495802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154495802 |
| Entity Type | Individual |
| Full Name | BRENT D LEE |
| Credential | D.D.S., M.S. |
| Practice Address |
165 N 14th Ave Pocatello ID 83201-4146 |
| Mailing Address |
Po Box 6033 165 N 14th Ave Pocatello ID 83205-6033 |
| Practice Telephone | 2082322807 |
| Practice Fax Number | 2082328118 |
| Mailing Telephone | 2082322807 |
| Mailing Fax Number | 2082328118 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D1494 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | RAILROAD | 000010009592 | 01 |
| ID | BLUE CROSS | 6M097 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689888505 | Brent Younghoon Lee | Internal Medicine | 9701 Sw Barnes Rd Ste 300, Portland, OR 97225-6689 | 2007-05-09 |
| 1851523732 | Brent Lee | Dentist | 7723 Clearview Church Ln, Lyles, TN 37098-1674 | 2009-08-11 |
| 1932290376 | Brent R Lee | Anesthesiology | 4320 Seminary Rd, Alexandria, VA 22304-1535 | 2006-09-28 |
| Street Address |
165 N 14TH AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184798811 | Mark Ensio Baker | Dentist | 165 N 14th Ave, Pocatello, ID 83201-4146 | 2006-11-17 |
| 1649453275 | Facial & Oral Surgery Associates, Inc. | Dentist | 165 N 14th Ave, Pocatello, ID 83201-4146 | 2007-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184798811 | Mark Ensio Baker | Dentist | 165 N 14th Ave, Pocatello, ID 83201-4146 | 2006-11-17 |
| 1649453275 | Facial & Oral Surgery Associates, Inc. | Dentist | 165 N 14th Ave, Pocatello, ID 83201-4146 | 2007-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710364427 | Gates Dentistry, Pllc | Dentist | 2165 N. Merritt Creek Loop, Coeur D Alene, ID 83814 | 2015-05-01 |
| 1124433743 | Arman Haghighi | Dentist | 403 S 11th St Ste 300, Boise, ID 83702-6968 | 2014-06-23 |
| 1003242769 | Dewayne Laverne Briscoe | Dentist | 404 Fairway Loop, Sun Valley, ID 83353 | 2013-09-25 |
| 1013274661 | Treasure Valley Oral and Facial Surgery Pllc | Dentist | 1000 N. Curtis Rd, Suite 103, Boise, ID 83706 | 2012-04-20 |
| 1487910733 | Timothy Tracy O'brien | Dentist | 1613 12th Ave Rd Ste A, Nampa, ID 83686-6183 | 2012-04-11 |
| 1023398716 | Coeur D' Alene Oral Surgery | Dentist | 1027 E Sherman Ave, Coeur D Alene, ID 83814-4152 | 2011-08-25 |
| 1861645202 | Michael Verlyn Dabell | Dentist | 1550 N Crestmont Dr Ste G, Meridian, ID 83642-2177 | 2008-10-29 |
| 1295993145 | Stephen W Holm | Dentist | 3326 4th St Ste 2, Lewiston, ID 83501-4455 | 2008-05-28 |
| 1376689646 | Timothy Ted Hopkins | Dentist | 590 Falls Ave, Twin Falls, ID 83301-3314 | 2007-01-30 |
| 1851450498 | Donald Edwin Spengler | Dentist | 400 S Main Street, Hailey, ID 83333 | 2006-12-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.