=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356529671
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GENEVIEVE DEE DDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2008
-----------------------------------------------------
Last Update Date | 02/08/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 181 2ND AVE STE 575
-----------------------------------------------------
City | SAN MATEO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94401-3838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-343-1727
-----------------------------------------------------
Fax | 650-343-7464
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 181 2ND AVE STE 575
-----------------------------------------------------
City | SAN MATEO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94401-3838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-343-1727
-----------------------------------------------------
Fax | 650-343-7464
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | GENEVIEVE DEE
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 650-343-1727
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------