Provider Demographics
NPI:1629743877
Name:LEE, HA NEUI (DDS)
Entity Type:Individual
Prefix:
First Name:HA
Middle Name:NEUI
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 1:16180 NE 80TH ST APT 503
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2051
Mailing Address - Country:US
Mailing Address - Phone:443-668-9247
Mailing Address - Fax:
Practice Address - Street 1:13317 NE 175TH ST STE AA
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6815
Practice Address - Country:US
Practice Address - Phone:425-321-5614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE611924091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice