Provider Demographics
NPI:1598024127
Name:LEE, NANCY ANNA MOK (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ANNA MOK
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 1:3245 DUBLIN BLVD
Mailing Address - Street 2:APT. #107
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3245 DUBLIN BLVD
Practice Address - Street 2:APT. #107
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-4400
Practice Address - Country:US
Practice Address - Phone:650-575-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA609811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice