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MR. DUSTIN CHRISTOPHER LEE D.D.S.
NPI 1366721961
Dentist - General Practice in San Bruno, CA

Active since August 12, 2011Opted out of Medicare · through Jun 29, 2028
750 KAINS AVE, SAN BRUNO, CA 94066(650) 588-4255 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Jun 1, 2017 (2 updates tracked since 2017).

About Mr. Dustin Christopher Lee D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DUSTIN CHRISTOPHER LEE D.D.S. (NPI 1366721961) is an individual general practice provider in San Bruno, California, licensed in California (61807) and active in the NPI registry since August 2011. He has opted out of Medicare through June 29, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1366721961
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameMR. DUSTIN CHRISTOPHER LEECredential: D.D.S.
Location Address750 KAINS AVESan Bruno, CA 94066-3432
Mailing Address3801 Miranda Ave, Hcs-160Palo Alto, CA 94304-1207 · (310) 614-6884
Phone(650) 588-4255
Sole ProprietorNo
Enumeration DateAugust 12, 2011
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1366721961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 61807
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
750 KAINS AVE, San Bruno, CA 94066
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. Dustin Christopher Lee D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 29, 2016 through June 29, 2028.

Opt-Out Effective DateJune 29, 2016
Opt-Out In Effect ThroughJune 29, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRADLEY L PARKER DDS
Dentist (General Practice)
750 KAINS AVE
SAN BRUNO, CA 94066
San Mateo County (650) 588-4255
DUSTIN LEE, DDS, INC
Dentist (General Practice)
750 KAINS AVE
SAN BRUNO, CA 94066
San Mateo County (650) 588-4255
DR. CHRISTINA CHEN DDS
Dentist (General Practice)
750 KAINS AVE
SAN BRUNO, CA 94066
San Mateo County (650) 588-4255
CHRISTINA CHEN, DDS, INC.
Dentist (General Practice)
750 KAINS AVE
SAN BRUNO, CA 94066
San Mateo County (650) 588-4255

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dustin Lee's NPI number?

The NPI number for Dustin Lee is 1366721961. It was assigned to this individual provider in the NPPES registry on August 12, 2011.

Where is Dustin Lee located?

Dustin Lee practices at 750 Kains Ave, San Bruno, CA 94066. The listed phone number is (650) 588-4255.

What is Dustin Lee's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Dustin Lee enrolled in Medicare?

No. Dustin Lee has opted out of Medicare through June 29, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Dustin Lee was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.