Active NPI
Brian Lee, DDS
- Dentist
- Garden Grove, CA
National Provider Identifier
1124325733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60173
- Practice address
- 9432 Garden Grove Blvd
Garden Grove, CA 92844-1453 - Phone
- (949) 798-9591
- NPI assigned
- Feb 16, 2011
- Last updated
- Jul 25, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60173 | CA | Primary |
Addresses
Primary practice location
9432 Garden Grove Blvd
Garden Grove, CA 92844-1453
Mailing address
9432 Garden Grove Blvd
Garden Grove, CA 92844-1453
Phone (949) 798-9591
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60173 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leedentalgroup | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Hawthorne, CA
- NPI 1689112286
-
- General Practice Dentistry
- Garden Grove, CA
- NPI 1134590789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406246400000",
"number": "1124325733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9432 GARDEN GROVE BLVD",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928441453",
"telephone_number": "949-798-9591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9432 GARDEN GROVE BLVD",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928441453",
"telephone_number": "949-798-9591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BRIAN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-16",
"last_updated": "2014-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "60173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.