Provider Demographics
NPI:1821210378
Name:LEE, HO-JHIN JONATHAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:HO-JHIN
Middle Name:JONATHAN
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 1:9310 CARMEL MOUNTAIN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2158
Mailing Address - Country:US
Mailing Address - Phone:858-484-4880
Mailing Address - Fax:858-484-3029
Practice Address - Street 1:9310 CARMEL MOUNTAIN RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2158
Practice Address - Country:US
Practice Address - Phone:858-484-4880
Practice Address - Fax:858-484-3029
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56834122300000X
ME36951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice