Healthcare Provider Details

I. General information

NPI: 1437209301
Provider Name (Legal Business Name): LEE M WEINSTEIN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12020 E SHEA BLVD #8
SCOTTSDALE AZ
85259-4179
US

IV. Provider business mailing address

12020 E SHEA BLVD #8
SCOTTSDALE AZ
85259-4179
US

V. Phone/Fax

Practice location:
  • Phone: 480-767-5600
  • Fax: 480-767-1950
Mailing address:
  • Phone: 480-767-5600
  • Fax: 480-767-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number6067
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: