Individual provider Active NPI

Robert Lee, DMD

  • General Practice Dentistry
  • Irvine, CA
National Provider Identifier
1861897548
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
108622 Issued in CA
Practice address
4940 Irvine Blvd Ste 203
Irvine, CA 92620-1960
Phone
(714) 730-0491
NPI assigned
Oct 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6568 NV
General Practice Dentistry 1223G0001X 108622 CA Primary
Dentist 122300000X 6568 NV

Addresses

Primary practice location

4940 Irvine Blvd Ste 203
Irvine, CA 92620-1960

Mailing address

4940 Irvine Blvd Ste 203
Irvine, CA 92620-1960
Phone (714) 730-0491

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

LicenseStateTypeSpecialty
108622CAMDGeneral Practice Dentistry
6568NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Lee DMD Inc CurrentSince Jan 7, 2024 Accepting new patients

Locations

4940 Irvine Blvd
Ste 203
Irvine, CA 92620
Phone (714) 730-0491

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1861897548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 IRVINE BLVD STE 203",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201960",
            "telephone_number": "714-730-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 IRVINE BLVD STE 203",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201960",
            "telephone_number": "714-730-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-24",
        "last_updated": "2024-01-03",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6568",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108622",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.