NPIMap

Organization Active NPI

Christine N Lee DMD a Professional Dental Corporation

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1174946206
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61952 Issued in CA
Legal business name
CHRISTINE N LEE DMD A PROFESSIONAL DENTAL CORPORATION
Practice address
9381 E Stockton Blvd
Suite 120
Elk Grove, CA 95624-5068
Phone
(916) 686-4212
Fax
(916) 686-4217
NPI assigned
Jan 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Authorized official

Name
Christine Nam Lee, DMDNPI 1225300668
Title
President
Phone
(916) 686-4212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 61952 CA Primary

Addresses

Primary practice location

9381 E Stockton Blvd
Suite 120
Elk Grove, CA 95624-5068

Mailing address

9381 E Stockton Blvd
Suite 120
Elk Grove, CA 95624-5068
Phone (916) 686-4212

Other names 1

  • Family Smile Center Doing business as

National Provider Directory

National Provider Directory

Locations

9381 E Stockton Blvd
Ste 120
Elk Grove, CA 95624
Phone (916) 686-4212

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1174946206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9381 E STOCKTON BLVD",
            "address_2": "SUITE 120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245068",
            "telephone_number": "916-686-4212",
            "fax_number": "916-686-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9381 E STOCKTON BLVD",
            "address_2": "SUITE 120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245068",
            "telephone_number": "916-686-4212",
            "fax_number": "916-686-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE N LEE DMD A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "NAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-686-4212",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Smile Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.

Verify at the official NPI Registry.