Provider Demographics
NPI:1942467055
Name:LEE, SANG WOOK (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:WOOK
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 1:7535 LITTLE RIVER TPKE STE 310C
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2989
Mailing Address - Country:US
Mailing Address - Phone:202-352-1444
Mailing Address - Fax:
Practice Address - Street 1:7535 LITTLE RIVER TPKE STE 310C
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2989
Practice Address - Country:US
Practice Address - Phone:202-352-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50052637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist