Provider Demographics
NPI:1578618864
Name:LEE, JENNIFER CHENG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CHENG
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 1:1314 S KING ST STE 725
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1942
Mailing Address - Country:US
Mailing Address - Phone:808-596-2285
Mailing Address - Fax:808-591-0668
Practice Address - Street 1:1314 S KING ST STE 725
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1942
Practice Address - Country:US
Practice Address - Phone:808-596-2285
Practice Address - Fax:808-591-0668
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT20651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice