Jason S Lee DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JASON S LEE DDS INC

Doing business as

Signature Dental Group

Practice address

1183 E Foothill Blvd
Unit 240
Upland, CA 91786-4049

Phone

(909) 981-6882

Fax

(909) 981-0276

NPI assigned

Jan 23, 2007

Last updated

Dec 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason S Lee, DDSNPI 1528112257

Title

Ceo

Phone

(909) 910-8282

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Signature Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason S Lee, DDS

  • General Practice Dentistry
  • Upland, CA
  • NPI 1528112257
  Authorized official Same address or phone

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230422400000",
    "number": "1912052978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "UNIT 240",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864049",
            "telephone_number": "909-981-6882",
            "fax_number": "909-981-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "UNIT 240",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864049",
            "telephone_number": "909-981-6882",
            "fax_number": "909-981-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON S LEE DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-12-28",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-910-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL # FOR UPLAND",
            "identifier": "247386",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93055-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA NUMBER",
            "identifier": "01604010",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA HEALTHY FAMILY",
            "identifier": "G98378-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Upland, CA
• Providers in Upland, 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 Dec 28, 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.