Active NPI
Robert Lee, DMD
- General Practice Dentistry
- Irvine, CA
National Provider Identifier
1861897548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 108622
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 108622 | CA | MD | General Practice Dentistry |
| 6568 | NV | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert Lee DMD Inc | Current | 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.
-
- Dental Clinic/Center
- Irvine, CA
- NPI 1003685397
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.