Provider Demographics
NPI:1245737246
Name:JASON J LEE ,DDS, INC
Entity Type:Organization
Organization Name:JASON J LEE ,DDS, INC
Other - Org Name:THE SMILE COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JUNG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-309-5501
Mailing Address - Street 1:3555 MONROE ST STE 50
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7818
Mailing Address - Country:US
Mailing Address - Phone:408-309-5501
Mailing Address - Fax:
Practice Address - Street 1:3555 MONROE ST STE 50
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7818
Practice Address - Country:US
Practice Address - Phone:408-309-5501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-07
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62858261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental