Look up the most recent NPI and PECOS records

Min Dennis Lee

Dentist

Dental Providers

3737 Moraga Ave, Ste A205, San Diego, CA 92117

PECOS Enrollment

Based on the most recent information from CMS, provider Min Dennis Lee does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1609980663
Provider Type
Individual
Full Name
Lee, Min Dennis
Title
Dr.
Credential
DDS

Gender
Male
Sole Proprietor
No
Enumeration Date
8/18/2006
Last Updated
7/8/2007

Contact Information

Practice Location

3737 Moraga Ave, Ste A205, San Diego, CA 92117

(858) 273-2232

(858) 273-2639

Mailing Location

2547 Old Quarry Rd, #932, San Diego, CA 92108

(619) 846-6205

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 39676 California

Provider Identifiers

ID	Description	Issuer
ID B3967601	Description Other	Issuer DENTICAL California
ID 849453	Description Other	Issuer UNITED CONCORDIA California

Min Dennis Lee

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Anderson, Darian L

Aldabe, Ali Mahmoud

Fariba, Tina S

Srinivasan, Hemamalini

Mallari, Danica Charisma

Levine, Robert L

Kenny, Kevin M

Lai, Joseph Hermes

Patel, Divya Yogesh

Assadi, Sadaf