Individual provider Active NPI

Brian Yun Lee, DDS

  • General Practice Dentistry
  • Lancaster, CA
National Provider Identifier
1053361907
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43184 Issued in CA
Practice address
1629 W Avenue J
Suite 103
Lancaster, CA 93534-2830
Phone
(661) 948-7722
Fax
(661) 948-7744
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43184 CA Primary

Addresses

Primary practice location

1629 W Avenue J
Suite 103
Lancaster, CA 93534-2830

Mailing address

1629 W Avenue J
Suite 103
Lancaster, CA 93534-2830
Phone (661) 948-7722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160525002985 CA Order and Referring Only - DentistPractitioner - Dentist 7719277110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael K McCray MD Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1053361907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 W AVENUE J",
            "address_2": "SUITE 103",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342830",
            "telephone_number": "661-948-7722",
            "fax_number": "661-948-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 W AVENUE J",
            "address_2": "SUITE 103",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342830",
            "telephone_number": "661-948-7722",
            "fax_number": "661-948-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRIAN",
        "middle_name": "YUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.