Individual provider Active NPI

Daniel Lee, DDS

  • General Practice Dentistry
  • Rohnert Park, CA
National Provider Identifier
1205310182
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
102944 Issued in CA
Practice address
5900 State Farm Dr FL 2
Rohnert Park, CA 94928-2149
Phone
(707) 559-7500
NPI assigned
Sep 18, 2018
Last updated
Apr 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34601 TX
General Practice Dentistry 1223G0001X 102944 CA Primary

Addresses

Primary practice location

5900 State Farm Dr FL 2
Rohnert Park, CA 94928-2149

Mailing address

43913 S Moray St
Fremont, CA 94539-5942
Phone (510) 579-3772

Other practice location 1

6808 Harrisburg Blvd
Houston, TX 77011-4626
Phone (713) 928-6600

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

LicenseStateTypeSpecialty
34601TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Petaluma Health Center, Inc. CurrentSince Jun 3, 2025 Accepting new patients
Houston DDS, PC General Practice Past Accepting new patients
Houston Dentistry PC General Practice Past Accepting new patients

Locations

5900 State Farm Dr
Fl 2
Rohnert Park, CA 94928
Phone (707) 559-7600

Interoperability endpoints

  • Direct secure messaging: dlee585076@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1205310182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43913 S MORAY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395942",
            "telephone_number": "510-579-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 STATE FARM DR FL 2",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282149",
            "telephone_number": "707-559-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6808 Harrisburg Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770114626",
            "country_code": "US",
            "telephone_number": "713-928-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34601",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.