Active NPI
Renee Eunhae Lee, DDS
- Dentist
- Twentynine Palms, CA
National Provider Identifier
1063297703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS111840
- Practice address
- PO Box 788250
Twentynine Palms, CA 92278-8250 - Phone
- (760) 830-2117
- Fax
- (760) 830-2011
- NPI assigned
- Aug 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 13468651-9921 | UT | |
| Dentist | 122300000X | DDS111840 | CA | Primary |
Addresses
Primary practice location
PO Box 788250
Twentynine Palms, CA 92278-8250
Mailing address
7120 Palo Alto Ave Unit 4
Yucca Valley, CA 92284
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 |
|---|---|---|---|
| DDS111840 | CA | MD | Dentist |
| 13468651-9921 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1063297703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7120 PALO ALTO AVE UNIT 4",
"city": "YUCCA VALLEY",
"state": "CA",
"postal_code": "92284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 788250",
"city": "TWENTYNINE PALMS",
"state": "CA",
"postal_code": "922788250",
"telephone_number": "760-830-2117",
"fax_number": "760-830-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "RENEE",
"middle_name": "EUNHAE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-30",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "13468651-9921",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS111840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twentynine Palms, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.