MEDICARE: DR. SHANNON KELLY LEE D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6446	NV

General Provider Information

NPI Number	:	1649602152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANNON KELLY LEE D.M.D.

Provider Business Mailing Address
First Line	:	3896 N MLK BLVD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-6603
Country	:	US
Telephone Number	:	702-614-1792
Fax Number	:	702-933-0190

Provider Business Practice Location Address
First Line	:	3896 N MLK BLVD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-6603
Country	:	US
Telephone Number	:	702-614-1792
Fax Number	:	702-933-0190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2013
Last Update Date	:	05/07/2015

Similar Medicare Providers

1417014762 — DR. MICHAEL H ROWE DDS
Practice Location Address:

3896 N MARTIN L KING BLVD
NORTH LAS VEGAS, NV
89032-6603

Practice Phone: 702-614-1792
Practice Fax: 702-933-0190

1225207251 — JAREN TOLMAN JENSEN DDS
Practice Location Address:

3896 N MARTIN L KING BLVD
NORTH LAS VEGAS, NV
89032-6603

Practice Phone: 702-614-1792
Practice Fax:

1497091367 — SAMIRA FAROKH D.M.D
Practice Location Address:

3896 N MLK BLVD
NORTH LAS VEGAS, NV
89032-6603

Practice Phone: 702-395-5437
Practice Fax: 702-933-0190

1568801231 — DR. POUYA PARTOVI DDS, MD
Practice Location Address:

3896 N MLK BLVD
NORTH LAS VEGAS, NV
89032-6603

Practice Phone: 415-476-8221
Practice Fax:

1952497984 — LEE MLK DENTAL GROUP, PC
Practice Location Address:

3896 N MARTIN LUTHER KING BLVD
N LAS VEGAS, NV
89032-6603

Practice Phone: 702-614-1792
Practice Fax: 702-933-0190

1730587007 — SUSAN OLSON D.M.D
Practice Location Address:

3896 N MARTIN L KING BLVD
N LAS VEGAS, NV
89032-6603

Practice Phone: 702-614-1792
Practice Fax:

Directions to “ DR. SHANNON KELLY LEE D.M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.