Provider Demographics
NPI:1518213479
Name:LEE, YEHOON (DDS)
Entity Type:Individual
Prefix:
First Name:YEHOON
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 EAST AVE # 5
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1628
Mailing Address - Country:US
Mailing Address - Phone:951-452-6119
Mailing Address - Fax:
Practice Address - Street 1:1430 EAST AVE # 5
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1628
Practice Address - Country:US
Practice Address - Phone:951-452-6119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3725122300000X
CA102274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist