Provider Demographics
NPI:1003095225
Name:LEE, ESTHER JIHAE
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:JIHAE
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ESTHER
Other - Middle Name:JIHAE
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5308 SE 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-5631
Mailing Address - Country:US
Mailing Address - Phone:503-775-4000
Mailing Address - Fax:
Practice Address - Street 1:5308 SE 52ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-5631
Practice Address - Country:US
Practice Address - Phone:503-775-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD91281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice