Active NPI
Brian P Lee, D.D.S.
- Pediatric Dentistry
- Diamond Bar, CA
National Provider Identifier
1477094795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 101822
- Practice address
- 1616 Range CT
Diamond Bar, CA 91765-4318 - Phone
- (626) 715-6328
- NPI assigned
- Mar 20, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 101822 | CA | |
| Pediatric Dentistry | 1223P0221X | 101822 | CA | Primary |
Addresses
Primary practice location
1616 Range CT
Diamond Bar, CA 91765-4318
Mailing address
1616 Range CT
Diamond Bar, CA 91765-4318
Phone (626) 715-6328
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
| License | State | Type | Specialty |
|---|---|---|---|
| 101822 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566345600000",
"number": "1477094795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 RANGE CT",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917654318",
"telephone_number": "626-715-6328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 RANGE CT",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917654318",
"telephone_number": "626-715-6328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BRIAN",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2019-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "101822",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "101822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diamond Bar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.