Jia Y Lee, DDS
Individual provider Active NPI Dentist · Alta Loma, CA
NPI 1992849939 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992849939
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 43358 (CA)
- Practice address
- 9320 Baseline Rd Ste E
Alta Loma, CA 91701-5829 - Phone
- (909) 989-5598
- Fax
- (909) 989-7229
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43358 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jia Y Lee DDS Inc | Current | Accepting new patients |
Locations
9477 Haven Ave
Rancho Cucamonga, CA 91730
Phone (909) 989-5598
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 43358 | CA | Yes |
Addresses
Primary practice location
9320 Baseline Rd Ste E
Alta Loma, CA 91701-5829
Mailing address
9320 Baseline Rd Ste E
Alta Loma, CA 91701-5829
Phone (909) 989-5598
Other providers in Alta Loma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.