NPIMap

Organization Active NPI

C. Jack Lee, D.M.D., Inc.

  • Dental Clinic/Center
  • Fullerton, CA
National Provider Identifier
1851592950
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
45903 Issued in CA
Legal business name
C. JACK LEE, D.M.D., INC.
Practice address
1321 N Harbor Blvd
Suite 200
Fullerton, CA 92835-4124
Phone
(714) 871-8343
Fax
(714) 871-2338
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Authorized official

Name
Dr. C. Jack Lee, D.M.D.
Title
Owner
Phone
(714) 871-8343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 45903 CA Primary

Addresses

Primary practice location

1321 N Harbor Blvd
Suite 200
Fullerton, CA 92835-4124

Mailing address

1321 N Harbor Blvd
Suite 200
Fullerton, CA 92835-4124
Phone (714) 871-8343

National Provider Directory

National Provider Directory

Locations

1321 N Harbor Blvd
Ste 200
Fullerton, CA 92835
Phone (714) 871-8343

Practitioners & affiliated clinicians

Practitioners 1

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": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1851592950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N HARBOR BLVD",
            "address_2": "SUITE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354124",
            "telephone_number": "714-871-8343",
            "fax_number": "714-871-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N HARBOR BLVD",
            "address_2": "SUITE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354124",
            "telephone_number": "714-871-8343",
            "fax_number": "714-871-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. JACK LEE, D.M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-871-8343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "45903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.