Provider Demographics
NPI:1710409446
Name:LEE, JOHN HANS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HANS
Last Name:LEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23707 HIGHLAND VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1167
Mailing Address - Country:US
Mailing Address - Phone:510-725-8933
Mailing Address - Fax:
Practice Address - Street 1:23707 HIGHLAND VALLEY RD
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1167
Practice Address - Country:US
Practice Address - Phone:510-725-8933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1015651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice