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General NPI Number Information
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NPI Number | 1972585107
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Entity Type | Individual
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Provider Name | LEE E ROUNDY D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | CORNER OF ROUTE N12 AND N7
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City | FORT DEFIANCE
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State | AZ
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Zip | 86504-0649
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Country | US
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Telephone | 928-729-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 649 ATTN: REVENUE GENERATION
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City | FORT DEFIANCE
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State | AZ
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Zip | 86504-0649
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Country | US
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Telephone |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 5529129-9923
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License Number State | UT
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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 | 5529129-9921
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | S6-194C
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License Number State | NV
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