Mason Y. Lee, DDS, a Professional Corp

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

42929 Issued in CA

Legal business name

MASON Y. LEE, DDS, A PROFESSIONAL CORP

Practice address

750 Las Gallinas Ave Ste 207
San Rafael, CA 94903-3432

Phone

(415) 472-5040

Fax

(415) 472-5043

NPI assigned

Jan 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mason Y Lee, DDS, MD

Title

President

Phone

(415) 472-5040

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1013305689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE STE 207",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033432",
            "telephone_number": "415-472-5040",
            "fax_number": "415-472-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE STE 207",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033432",
            "telephone_number": "415-472-5040",
            "fax_number": "415-472-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON Y. LEE, DDS, A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MASON",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-472-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "42929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana M Martinez
• Gabriel Martinez
• Vicki S. Martinez, MD
• Ashley Marty, PPS
• Colin Daniel Maslan, LCSW
• Amanda Mason, PSY.D
• Ian Charles Mason, MFT
• Michael E. Mason, MD
• Brian R. Matas, MD
• Carolyn Haas Matranga

• Oral and Maxillofacial Surgery Clinic/Center in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.