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DR. THEODORE TAK LEE D.D.S.
NPI 1912311234
Dentist in Bremerton, WA

Active since June 14, 2014PECOS Enrolled
616 6TH ST, BREMERTON, WA 98337(360) 377-3776 Get Directions Write a Review

NPPES record last updated: August 18, 2014. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Theodore Tak Lee D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE TAK LEE D.D.S. (NPI 1912311234) is an individual dentist in Bremerton, Washington, licensed in Washington (DE60477328) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912311234
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. THEODORE TAK LEECredential: D.D.S.
Location Address616 6TH STBremerton, WA 98337-1420
Mailing AddressPo Box 960Bremerton, WA 98337-0212 · (360) 377-3776
Phone(360) 377-3776
Sole ProprietorNo
Enumeration DateJune 14, 2014
Last NPPES UpdateAugust 18, 2014
✔ NPI 1912311234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WA · DE60477328
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
616 6TH ST, Bremerton, WA 98337
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Theodore Tak Lee D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Theodore Lee reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sun River Health Inc
2,407 mi
Federally Qualified Health Center (FQHC)
3360 ROUTE 343, HUDSON RIVER HEALTHCARE, INC.
Amenia, NY 12501
  • Reassigned Medicare billing, New York enrollment
  • 683 clinicians in this Medicare group
NPI 1568526838 (845) 373-9006

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98337 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OTIS MALCOLM BLAIR PHARMACIST
Pharmacist
616 6TH ST
BREMERTON, WA 98337
Kitsap County (360) 475-3732
DEANDRE FRAY ARNP
Nurse Practitioner
616 6TH ST
BREMERTON, WA 98337
Kitsap County (253) 833-7711
BRET M KELLY
Counselor (Mental Health)
616 6TH ST
BREMERTON, WA 98337
Kitsap County (360) 377-3776
DR. LAYNE MICHELLE WANDER
Pharmacist
616 6TH ST
BREMERTON, WA 98337
Kitsap County (360) 478-2366
DR. DARREN M CHOTINER M.D.
Family Medicine
616 6TH ST
BREMERTON, WA 98337
Kitsap County (360) 377-3776
JULIA LANGRELL PHARMD
Pharmacist
616 6TH ST
BREMERTON, WA 98337
Kitsap County (360) 377-3776
ZACKARY BUDISELIC ARNP
Nurse Practitioner (Family)
616 6TH ST
BREMERTON, WA 98337
Kitsap County (360) 377-3776
CRESSA HAUGE RDH
Dental Hygienist
616 6TH ST
BREMERTON, WA 98337
Kitsap County (360) 377-3776

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Lee's NPI number?

The NPI number for Theodore Lee is 1912311234. It was assigned to this individual provider in the NPPES registry on June 14, 2014.

Where is Theodore Lee located?

Theodore Lee practices at 616 6th St, Bremerton, WA 98337. The listed phone number is (360) 377-3776.

What is Theodore Lee's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Theodore Lee enrolled in Medicare?

Yes. Theodore Lee is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Theodore Lee's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Lee reassigns Medicare benefits to Sun River Health Inc (Amenia, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theodore Lee's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Theodore Lee was last updated on August 18, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.