Healthcare Provider Details

I. General information

NPI: 1366359622
Provider Name (Legal Business Name): GARRETT LEE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1668 MAIN ST STE B1
RAMONA CA
92065-5258
US

IV. Provider business mailing address

PO BOX 1175
RAMONA CA
92065-0860
US

V. Phone/Fax

Practice location:
  • Phone: 760-789-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS113557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: