Individual provider Active NPI

Stanley Tak Lee, DDS

  • Dentist
  • San Jose, CA
National Provider Identifier
1891893384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27327 Issued in CA
Practice address
1095 Branham Lane
#101
San Jose, CA 95136
Phone
(408) 978-8888
Fax
(408) 978-7767
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27327 CA Primary

Addresses

Primary practice location

1095 Branham Lane
#101
San Jose, CA 95136

Mailing address

1095 Branham Lane
#101
San Jose, CA 95136
Phone (408) 978-8888

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
I20160428000298 CA Order and Referring Only - DentistPractitioner - Dentist 3577862416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27727CAMDClinical Social Worker
27327CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Lee Past Accepting new patients
Christine Y Lee Dental Corporation PastSince Jun 3, 2025 Accepting new patients

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891893384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 BRANHAM LANE",
            "address_2": "#101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95136",
            "telephone_number": "408-978-8888",
            "fax_number": "408-978-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 BRANHAM LANE",
            "address_2": "#101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95136",
            "telephone_number": "408-978-8888",
            "fax_number": "408-978-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "STANLEY",
        "middle_name": "TAK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "27327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.