Provider Demographics
NPI:1568537892
Name:LEE, HSIEN-CHANG
Entity Type:Individual
Prefix:
First Name:HSIEN-CHANG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 JERICHO TPKE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2937
Mailing Address - Country:US
Mailing Address - Phone:631-462-4266
Mailing Address - Fax:631-462-4288
Practice Address - Street 1:2171 JERICHO TPKE
Practice Address - Street 2:SUITE 235
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2937
Practice Address - Country:US
Practice Address - Phone:631-462-4266
Practice Address - Fax:631-462-4288
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0493071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice