Healthcare Provider Details
I. General information
NPI: 1285569715
Provider Name (Legal Business Name): CHRISTOPHER LEE, DDS, A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1949 PARKSIDE DR
CONCORD CA
94519-2525
US
IV. Provider business mailing address
1025 LAKERIDGE PL
SAN RAMON CA
94582-4818
US
V. Phone/Fax
- Phone: 925-399-8972
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
N
LEE
Title or Position: CEO
Credential: DDS
Phone: 925-399-8972