Provider Demographics
NPI:1619124633
Name:LEE, SUNG MIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNG MIN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SUNG
Other - Middle Name:MIN
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2030 HUDSON ST APT 723
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7218
Mailing Address - Country:US
Mailing Address - Phone:201-638-2071
Mailing Address - Fax:
Practice Address - Street 1:34 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2102
Practice Address - Country:US
Practice Address - Phone:098-883-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054195-011223P0300X
NJ22DI023761001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics