Provider Demographics
NPI:1417025255
Name:LEE, WILLIAM SUNGKI (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SUNGKI
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:SUNGKI
Other - Middle Name:WILLIAM
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6400 BEULAH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2628
Mailing Address - Country:US
Mailing Address - Phone:703-347-9876
Mailing Address - Fax:
Practice Address - Street 1:6400 BEULAH ST STE 103
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2628
Practice Address - Country:US
Practice Address - Phone:703-347-9876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014109801223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics