Healthcare Provider Details

I. General information

NPI: 1982151031
Provider Name (Legal Business Name): URIE K LEE MD, DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 28TH ST STE 200
BOULDER CO
80301-1263
US

IV. Provider business mailing address

2625 28TH ST STE 200
BOULDER CO
80301-1263
US

V. Phone/Fax

Practice location:
  • Phone: 303-341-7151
  • Fax:
Mailing address:
  • Phone: 303-341-7151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9533
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0438000537
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101286380
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number103516
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401419565
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number0076987
License Number StateCO
# 7
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number00206542
License Number StateCO
# 8
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number32375
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: