Provider Demographics
NPI:1770216996
Name:JEE, SANGYOON (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANGYOON
Middle Name:
Last Name:JEE
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 1:459 NORTHWEST HWY APT 2202
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4246
Mailing Address - Country:US
Mailing Address - Phone:410-269-3204
Mailing Address - Fax:
Practice Address - Street 1:419 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5728
Practice Address - Country:US
Practice Address - Phone:410-269-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38463122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist