Tim Lee, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS63953 Issued in CA

Practice address

9450 Fairway Dr
Roseville, CA 95678-3588

Phone

(504) 202-7789

NPI assigned

Feb 19, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1336461284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 HUTLEY WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957467161",
            "telephone_number": "504-202-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 FAIRWAY DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956783588",
            "telephone_number": "504-202-7789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1016 Riley St",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956303265",
            "country_code": "US",
            "telephone_number": "916-605-0468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "TIM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-19",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS63953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley C. Lee, PHARM. D
• Steve Eldon Lee, LMFT
• Steven F Lee, D.D.S.
• Susan Lee, RN
• Tayler Lee, ASSOCIATE MFT
• Yauk Kaung Lee, MD
• James Leek, MD
• Robin Ann Leeming-Martinez
• Melissa Leeolou
• Stanley W Leff, MD

• Oral and Maxillofacial Surgery (Dentist) in Roseville, CA
• Providers in Roseville, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.