Provider Demographics
NPI:1407183742
Name:MELVIN WC LEE, DDS INC
Entity Type:Organization
Organization Name:MELVIN WC LEE, DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:WC
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-591-2809
Mailing Address - Street 1:1314 S. KING STREET,
Mailing Address - Street 2:STE 608
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1941
Mailing Address - Country:US
Mailing Address - Phone:808-591-2809
Mailing Address - Fax:
Practice Address - Street 1:1314 S. KING STREET,
Practice Address - Street 2:SUITE 608
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1941
Practice Address - Country:US
Practice Address - Phone:808-591-2809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI108401OtherHDS
HI482359OtherUNITED CONCORDIA
HIJ5285-0OtherHMSA