Individual provider Active NPI

Grace Unehae Lee, MD DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Sacramento, CA
National Provider Identifier
1407903131
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
C51714 Issued in CA
Practice address
3604 Fair Oaks Blvd
Suite 1a
Sacramento, CA 95864-7256
Phone
(916) 283-8818
Fax
(916) 283-8815
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X C51714 CA Primary

Addresses

Primary practice location

3604 Fair Oaks Blvd
Suite 1a
Sacramento, CA 95864-7256

Mailing address

2398 Fair Oaks Blvd
Suite 1a
Sacramento, CA 95825
Phone (916) 283-8818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2025 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620432000000",
    "number": "1407903131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2398 FAIR OAKS BLVD",
            "address_2": "SUITE 1A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "916-283-8818",
            "fax_number": "916-283-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 FAIR OAKS BLVD",
            "address_2": "SUITE 1A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958647256",
            "telephone_number": "916-283-8818",
            "fax_number": "916-283-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GRACE",
        "middle_name": "UNEHAE",
        "name_prefix": "Mrs.",
        "credential": "MD DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "C51714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.