Provider Demographics
NPI:1639749013
Name:LEE, SION DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:SION
Middle Name:DAVID
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BELLACASA WAY APT 204
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3193
Mailing Address - Country:US
Mailing Address - Phone:804-929-2536
Mailing Address - Fax:
Practice Address - Street 1:6255 COLLEGE DR STE E
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2768
Practice Address - Country:US
Practice Address - Phone:757-967-0889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014175021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice