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General NPI Number Information
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NPI Number | 1669561114
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Entity Type | Individual
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Provider Name | JASON LIPTON DDS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 351 N SAN MATEO DR
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City | SAN MATEO
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State | CA
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Zip | 94401-2513
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Country | US
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Telephone | 650-344-7131
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Fax | 650-344-1909
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Provider Business Mailing Address
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Address Line | 351 N SAN MATEO DR
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City | SAN MATEO
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State | CA
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Zip | 94401-2513
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Country | US
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Telephone | 650-344-7131
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Fax | 650-344-1909
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 200579547
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 46874
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License Number State | CA
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