NPIMap

Organization Active NPI

Lee and Dubanski Dental Corporation

  • General Practice Dentistry
  • Rocklin, CA
National Provider Identifier
1508901323
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35666 Issued in CA
Legal business name
LEE AND DUBANSKI DENTAL CORPORATION
Practice address
4750 Rocklin Rd
Suite 100
Rocklin, CA 95677-3334
Phone
(916) 315-3558
Fax
(916) 315-9301
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Authorized official

Name
Dr. Gertrude Lee, DMDNPI 1255615019
Title
Pres.
Phone
(916) 315-3558

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 35666 CA Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

4750 Rocklin Rd
Suite 100
Rocklin, CA 95677-3334

Mailing address

4750 Rocklin Rd
Suite 100
Rocklin, CA 95677-3334
Phone (916) 315-3558

Other names 1

  • ROCKLIN FAMILY DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1508901323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 ROCKLIN RD",
            "address_2": "SUITE 100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773334",
            "telephone_number": "916-315-3558",
            "fax_number": "916-315-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 ROCKLIN RD",
            "address_2": "SUITE 100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773334",
            "telephone_number": "916-315-3558",
            "fax_number": "916-315-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE AND DUBANSKI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GERTRUDE",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "916-315-3558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35666",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROCKLIN FAMILY DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.