Active NPI
Michael Thomas Lee, D.D.S.
- Dentist
- Alameda, CA
National Provider Identifier
1629135835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36786
- Practice address
- 2049 Central Ave
Alameda, CA 94501-4296 - Phone
- (510) 521-3554
- Fax
- (510) 521-0164
- NPI assigned
- Jan 3, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 36786 | CA | Primary |
Addresses
Primary practice location
2049 Central Ave
Alameda, CA 94501-4296
Mailing address
2049 Central Ave
Alameda, CA 94501-4296
Phone (510) 521-3554
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 |
|---|---|---|---|
| 36786 | CA | MD | Dentist |
Interoperability endpoints
- mlee323668@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629135835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2049 CENTRAL AVE",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014296",
"telephone_number": "510-521-3554",
"fax_number": "510-521-0164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2049 CENTRAL AVE",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014296",
"telephone_number": "510-521-3554",
"fax_number": "510-521-0164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MICHAEL",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "36786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, 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.