Provider Demographics
NPI:1790214484
Name:LEE, LINDA MEE-YOUNG (DDS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MEE-YOUNG
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 1:11998 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-7101
Mailing Address - Country:US
Mailing Address - Phone:818-897-5055
Mailing Address - Fax:
Practice Address - Street 1:11998 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-7101
Practice Address - Country:US
Practice Address - Phone:818-897-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1014041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice