Active NPI
Min Dennis Lee, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1609980663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39676
- Practice address
- 3737 Moraga Ave
Ste A205
San Diego, CA 92117 - Phone
- (858) 273-2232
- Fax
- (858) 273-2639
- NPI assigned
- Aug 18, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 39676 | CA | Primary |
Addresses
Primary practice location
3737 Moraga Ave
Ste A205
San Diego, CA 92117
Mailing address
2547 Old Quarry Rd
#932
San Diego, CA 92108
Phone (619) 846-6205
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B3967601 | Other | CA | DENTICAL |
| 849453 | Other | CA | UNITED CONCORDIA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609980663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2547 OLD QUARRY RD",
"address_2": "#932",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92108",
"telephone_number": "619-846-6205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 MORAGA AVE",
"address_2": "STE A205",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92117",
"telephone_number": "858-273-2232",
"fax_number": "858-273-2639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MIN",
"middle_name": "DENNIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "39676",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "B3967601",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "849453",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.