Provider Demographics
NPI:1619359080
Name:LEI, JUNE Q (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:Q
Last Name:LEI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ENGLE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5122 YELM HWY SE
Practice Address - Street 2:SUITE E
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5034
Practice Address - Country:US
Practice Address - Phone:360-528-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0589891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics