Provider Demographics
NPI:1376735837
Name:LEE, SANG CHUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:CHUN
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 BREA HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92823-1800
Mailing Address - Country:US
Mailing Address - Phone:714-471-8421
Mailing Address - Fax:
Practice Address - Street 1:462 BREA HILLS AVE
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92823-1800
Practice Address - Country:US
Practice Address - Phone:714-471-8421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40649122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist