Provider Demographics
NPI:1659427052
Name:LEE, CHRISTIAN KINGSTON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:KINGSTON
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:324 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4327
Mailing Address - Country:US
Mailing Address - Phone:650-533-0679
Mailing Address - Fax:650-458-6441
Practice Address - Street 1:734 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2911
Practice Address - Country:US
Practice Address - Phone:650-289-9200
Practice Address - Fax:650-289-9582
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA501571223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry