Provider Demographics
NPI:1427006501
Name:LEE, SUNGHYUK (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNGHYUK
Middle Name:
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 1:986 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1300
Mailing Address - Country:US
Mailing Address - Phone:201-224-6401
Mailing Address - Fax:201-224-6406
Practice Address - Street 1:986 RIVER RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1300
Practice Address - Country:US
Practice Address - Phone:201-224-6401
Practice Address - Fax:201-224-6406
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0221821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice