Individual provider Active NPI

John Hans Lee, DMD

  • General Practice Dentistry
  • Diamond Bar, CA
National Provider Identifier
1710409446
Registry record updated Jul 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
101565 Issued in CA
Practice address
23707 Highland Valley Rd
Diamond Bar, CA 91765-1167
Phone
(510) 725-8933
NPI assigned
Jul 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 101565 CA Primary

Addresses

Primary practice location

23707 Highland Valley Rd
Diamond Bar, CA 91765-1167

Mailing address

23707 Highland Valley Rd
Diamond Bar, CA 91765-1167
Phone (510) 725-8933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171221001792 CA Order and Referring Only - DentistPractitioner - Dentist 2264790195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101565CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1710409446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23707 HIGHLAND VALLEY RD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651167",
            "telephone_number": "510-725-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23707 HIGHLAND VALLEY RD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651167",
            "telephone_number": "510-725-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "middle_name": "HANS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.