Provider Demographics
NPI:1578555371
Name:LEE, LELAND W (DDS)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:W
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:LELAND
Other - Middle Name:WC
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:23 S VINEYARD BLVD
Mailing Address - Street 2:STE 301
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2364
Mailing Address - Country:US
Mailing Address - Phone:808-523-9546
Mailing Address - Fax:808-523-9546
Practice Address - Street 1:23 S VINEYARD BLVD
Practice Address - Street 2:STE 301
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2364
Practice Address - Country:US
Practice Address - Phone:808-523-9546
Practice Address - Fax:808-523-9546
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-1049122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist