Healthcare Provider Details

I. General information

NPI: 1679790992
Provider Name (Legal Business Name): JASON GEE D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41250 12TH ST W STE A
PALMDALE CA
93551-1444
US

IV. Provider business mailing address

41250 12TH ST W STE A
PALMDALE CA
93551-1444
US

V. Phone/Fax

Practice location:
  • Phone: 661-267-0617
  • Fax: 661-726-9526
Mailing address:
  • Phone: 661-267-0617
  • Fax: 661-726-9526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number56158
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: