Active NPI
Jean Lee
- Dentist
- Sylmar, CA
National Provider Identifier
1306030465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56137
- Practice address
- 11998 Foothill Blvd
Sylmar, CA 91342-7101 - Phone
- (818) 897-5055
- NPI assigned
- Aug 31, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 56137 | CA | Primary |
Addresses
Primary practice location
11998 Foothill Blvd
Sylmar, CA 91342-7101
Mailing address
17405 Smoke Tree LN
Santa Clarita, CA 91387
Phone (415) 806-1176
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D56137 | Medicaid | CA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jean Lee DDS Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Sylmar, CA
- NPI 1861766768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1306030465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17405 SMOKE TREE LN",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "91387",
"telephone_number": "415-806-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11998 FOOTHILL BLVD",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913427101",
"telephone_number": "818-897-5055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JEAN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-31",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56137",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D56137",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.