Active NPI
Ruy Tsun Lee, DDS
- Dentist
- San Gabriel, CA
National Provider Identifier
1184760373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31059
- Practice address
- 1008 East Las Tunas Drive
Suite D
San Gabriel, CA 91776-1615 - Phone
- (626) 287-5988
- NPI assigned
- Jan 29, 2007
- 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 | 31059 | CA | Primary |
Addresses
Primary practice location
1008 East Las Tunas Drive
Suite D
San Gabriel, CA 91776-1615
Mailing address
1008 East Las Tunas Drive
Suite D
San Gabriel, CA 91776-1615
Phone (626) 287-5988
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D31059 | Other | CA | DENTI-CAL RENDERPROVIDER |
| G94163-01 | Other | CA | DENTI-CAL BILLINGPROVIDER |
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 |
|---|---|---|---|
| 31059 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184760373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 EAST LAS TUNAS DRIVE",
"address_2": "SUITE D",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917761615",
"telephone_number": "626-287-5988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 EAST LAS TUNAS DRIVE",
"address_2": "SUITE D",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917761615",
"telephone_number": "626-287-5988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "RUY",
"middle_name": "TSUN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "31059",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL RENDERPROVIDER",
"identifier": "D31059",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL BILLINGPROVIDER",
"identifier": "G94163-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.