Charles Peters Lee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25930 Issued in CA

Practice address

11092 Anderson Street
Llu School of Dentistry
Loma Linda, CA 92350

Phone

(909) 558-4613

Fax

(909) 558-4192

NPI assigned

Aug 22, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Tsaiteik Lee Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1891942744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11092 ANDERSON STREET",
            "address_2": "LLU SCHOOL OF DENTISTRY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92350",
            "telephone_number": "909-558-4613",
            "fax_number": "909-558-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11092 ANDERSON STREET",
            "address_2": "LLU SCHOOL OF DENTISTRY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92350",
            "telephone_number": "909-558-4613",
            "fax_number": "909-558-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHARLES",
        "middle_name": "PETERS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TSAITEIK",
            "last_name": "LEE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andrew Yoonkeun Lee, MD
• Arthur Yoon Lee
• Carol Dasom Lee
• Chanel Hana Lee
• Charles Lee, DO
• Christine Lai San Lee, M.D.
• Collin Lee, MD
• Corey Lee
• Dakory Lee
• David Y Lee, DDS

• General Practice Dentistry in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.