Healthcare Provider Details

I. General information

NPI: 1851219190
Provider Name (Legal Business Name): BRIAN LEW DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 SARATOGA AVE BLDG 3
SARATOGA CA
95070-6613
US

IV. Provider business mailing address

19509 ROBLE CT
SARATOGA CA
95070-4515
US

V. Phone/Fax

Practice location:
  • Phone: 408-477-2998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: