Active NPI
Michael J. Lee, D.M.D., M.S.
- Prosthodontics
- Los Gatos, CA
National Provider Identifier
1467432674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 54510
- Practice address
- 14535 S Bascom Ave
Los Gatos, CA 95032-2003 - Phone
- (408) 402-0100
- Fax
- (408) 402-0111
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 54510 | CA | Primary |
| General Practice Dentistry | 1223G0001X | 54510 | CA |
Addresses
Primary practice location
14535 S Bascom Ave
Los Gatos, CA 95032-2003
Mailing address
14535 S Bascom Ave
Los Gatos, CA 95032-2003
Phone (408) 402-0100
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54510 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260489600000",
"number": "1467432674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14535 S BASCOM AVE",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950322003",
"telephone_number": "408-402-0100",
"fax_number": "408-402-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14535 S BASCOM AVE",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950322003",
"telephone_number": "408-402-0100",
"fax_number": "408-402-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MICHAEL",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2009-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "54510",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "54510",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.