Active NPI
Joshua Lee
- Dentist
- San Antonio, TX
National Provider Identifier
1053685693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61178
- Practice address
- 4900 Medical Dr
San Antonio, TX 78229-5389 - Phone
- (213) 863-4805
- NPI assigned
- Feb 29, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27702 | TX | |
| Dentist | 122300000X | 61178 | CA | Primary |
Addresses
Primary practice location
4900 Medical Dr
San Antonio, TX 78229-5389
Mailing address
PO Box 29568
San Antonio, TX 78229-0568
Phone (213) 863-4805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27702 | TX | MD | Dentist |
| 61178 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370390400000",
"number": "1053685693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 29568",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782290568",
"telephone_number": "213-863-4805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782295389",
"telephone_number": "213-863-4805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOSHUA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-29",
"last_updated": "2013-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "27702",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.