Provider Demographics
NPI:1407442510
Name:LEE, JOSHUA CHUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
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 1:3321 BOTANICAL DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8746
Mailing Address - Country:US
Mailing Address - Phone:626-862-6810
Mailing Address - Fax:
Practice Address - Street 1:1164 NATIONAL DR STE 40
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1925
Practice Address - Country:US
Practice Address - Phone:844-707-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105872122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist