Individual provider Active NPI

Aaron Lee

  • Pediatric Dentistry
  • San Clemente, CA
National Provider Identifier
1437689395
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
101512 Issued in CA
Practice address
903 Calle Amanecer Ste 110
San Clemente, CA 92673-6253
Phone
(949) 433-3597
NPI assigned
Jun 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 101512 CA Primary

Addresses

Primary practice location

903 Calle Amanecer Ste 110
San Clemente, CA 92673-6253

Mailing address

903 Calle Amanecer Ste 110
San Clemente, CA 92673-6253
Phone (949) 361-2838

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
101512CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Dentistry of San Clemente CurrentSince Oct 15, 2023 Accepting new patients

Locations

903 Calle Amanecer
Ste 110
San Clemente, CA 92673
Phone (949) 361-2838

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, 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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1437689395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 CALLE AMANECER STE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736253",
            "telephone_number": "949-361-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 CALLE AMANECER STE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736253",
            "telephone_number": "949-433-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "AARON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "101512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.