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General NPI Number Information
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NPI Number | 1891356135
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Entity Type | Individual
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Provider Name | ESTHER LEE
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 148 PAVILION PKWY
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City | NEWPORT
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State | KY
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Zip | 41071-2884
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Country | US
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Telephone | 859-394-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 8616 PINE RD
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City | CINCINNATI
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State | OH
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Zip | 45242-7940
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Country | US
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Telephone | 502-657-9188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11085
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10624
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License Number State | KY
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