NPIMap

Organization Active NPI

Dustin Lee, DDS, Inc

  • General Practice Dentistry
  • San Bruno, CA
National Provider Identifier
1437687571
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61807 Issued in CA
Legal business name
DUSTIN LEE, DDS, INC
Doing business as
Simply Dentistry
Practice address
750 Kains Ave
San Bruno, CA 94066-3432
Phone
(650) 588-4255
NPI assigned
Jun 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Dustin Lee, DDSNPI 1366721961
Title
Owner President
Phone
(650) 588-4255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 61807 CA Primary

Addresses

Primary practice location

750 Kains Ave
San Bruno, CA 94066-3432

Mailing address

750 Kains Ave
San Bruno, CA 94066-3432
Phone (650) 588-4255

Other names 1

  • Simply Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

750 Kains Ave
San Bruno, CA 94066
Phone (650) 588-4255

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1437687571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 KAINS AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663432",
            "telephone_number": "650-588-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 KAINS AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663432",
            "telephone_number": "650-588-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUSTIN LEE, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "650-588-4255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simply Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bruno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.