Active NPI
Gary Wayne Lee, DDS
- General Practice Dentistry
- West Covina, CA
National Provider Identifier
1972689263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 29076
- Practice address
- 126 S Glendora Ave
West Covina, CA 91790-3035 - Phone
- (626) 918-8513
- NPI assigned
- Oct 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29076 | CA | Primary |
Addresses
Primary practice location
126 S Glendora Ave
West Covina, CA 91790-3035
Mailing address
6944 Via del Rio St
Long Beach, CA 90815-4863
Phone (562) 431-6273
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160520001113 | CA | Order and Referring Only - Dentist | 9032408695 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thompson, Crawford, Stewart, and Lee, | General Practice | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- West Covina, CA
- NPI 1225253032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972689263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6944 VIA DEL RIO ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908154863",
"telephone_number": "562-431-6273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 S GLENDORA AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917903035",
"telephone_number": "626-918-8513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "GARY",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "29076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.