Provider Demographics
NPI:1972643856
Name:LEE, SUNG YOUNG (DMD)
Entity Type:Individual
Prefix:
First Name:SUNG YOUNG
Middle Name:
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 1:1757 W CARSON ST STE E
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2828
Mailing Address - Country:US
Mailing Address - Phone:310-787-1233
Mailing Address - Fax:310-787-1239
Practice Address - Street 1:1757 W CARSON ST
Practice Address - Street 2:SUITE E
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501
Practice Address - Country:US
Practice Address - Phone:310-787-1233
Practice Address - Fax:310-787-1239
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist