|Provider Name||DAVID FORMOSAN LEE DDS|
|Provider Location Address||30 E 40TH ST RM 305 NEW YORK, NY 10016|
|Provider Mailing Address||4436 TIMBERLAKE DRIVE LOUISVILLE, TN 37777|
|NPI Entity Type||Individual|
|Is Sole Proprietor?||Yes|
|Is Organization Subpart?||N/A|
|Last Update Date||06-08-2020|
DAVID FORMOSAN LEE DDS
30 E 40TH ST RM 305
NEW YORK, NY
Phone: (212) 370-1919
DAVID FORMOSAN LEE DDS
4436 TIMBERLAKE DRIVE
Phone: (865) 970-2821
Fax: (865) 983-0870
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State|
Other Providers at the same location
The following provider is registered at the same or nearby location.
|NPI||Name / Type||Taxonomy||Address|
|1629490826||FORMOSO DENTAL PC |
|Dentist||30 E 40TH ST RM 305 |
NEW YORK, NY 10016
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.