S Lee Dental Corporation

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

S LEE DENTAL CORPORATION

Practice address

23571 Lake Dr
Crestline, CA 92325-9432

Phone

(909) 338-1782

NPI assigned

Nov 17, 2021

Organization subpart

No

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

Authorized official

Name

Sean Lee, DDSNPI 1497912281

Title

Owner

Phone

(909) 824-7000

Specialties & licenses 1

Addresses

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sean Lee, D.D.S.

  • General Practice Dentistry
  • San Bernardino, CA
  • NPI 1497912281
  NPD Authorized official
• Chelsea L Guest, DMD

  • Dentist
  • Crestline, CA
  • NPI 1992256549
  NPD (past)
• Sutheep Dave Srikureja, DDS

  • General Practice Dentistry
  • Montclair, CA
  • NPI 1962889006
  NPD (past)
• Julia E. Carlson, D.D.S.

  • General Practice Dentistry
  • Lake Havasu City, AZ
  • NPI 1497818652
  NPD (past)

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1801553540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23571 LAKE DR",
            "city": "CRESTLINE",
            "state": "CA",
            "postal_code": "923259432",
            "telephone_number": "909-338-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23571 LAKE DR",
            "city": "CRESTLINE",
            "state": "CA",
            "postal_code": "923259432",
            "telephone_number": "909-338-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S LEE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-824-7000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Elena Romero
• Jacqueline Rosas, AMFT
• Samantha Ross, LCSW
• Lorenzo Rundles, MSW
• S Lee Dental Corporation
• Rosa Maria Sandoval
• Kimberly Gaye Sasser-Wills, LVN
• Jayne M Schuljak
• Derek Joseph Schutt
• Jean Sherman, LVN

• Oral and Maxillofacial Surgery (Dentist) in Crestline, CA
• Providers in Crestline, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.