Dr Jeffrey Lee MD DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

G73560 Issued in CA

Legal business name

DR JEFFREY LEE MD DMD

Practice address

17452 Irvine Blvd
Suite 100
Tustin, CA 92780-3031

Phone

(714) 734-9363

Fax

(714) 734-9362

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Lee, MD DMD

Title

Owner Surgeon

Phone

(714) 734-9363

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377129600000",
    "number": "1932248085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17452 IRVINE BLVD",
            "address_2": "SUITE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803031",
            "telephone_number": "714-734-9363",
            "fax_number": "714-734-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17452 IRVINE BLVD",
            "address_2": "SUITE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803031",
            "telephone_number": "714-734-9363",
            "fax_number": "714-734-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JEFFREY LEE MD DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER SURGEON",
        "authorized_official_telephone_number": "714-734-9363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "00008",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "G73560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Tustin, CA
• Providers in Tustin, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.