Provider Demographics
NPI:1316558802
Name:JOHN K LEE DDS PLLC
Entity Type:Organization
Organization Name:JOHN K LEE DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KEUNHEE
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-495-9977
Mailing Address - Street 1:3300 E 1ST AVE STE 580
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5818
Mailing Address - Country:US
Mailing Address - Phone:303-495-9977
Mailing Address - Fax:
Practice Address - Street 1:3300 E 1ST AVE STE 580
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5818
Practice Address - Country:US
Practice Address - Phone:303-495-9977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty