Provider Demographics
NPI:1992853451
Name:LEE, JANICE Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:Y
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 1:170 CHANGEBRIDGE RD
Mailing Address - Street 2:SUITE D5-2
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9115
Mailing Address - Country:US
Mailing Address - Phone:973-227-1820
Mailing Address - Fax:973-227-1819
Practice Address - Street 1:170 CHANGEBRIDGE RD
Practice Address - Street 2:SUITE D5-2
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9115
Practice Address - Country:US
Practice Address - Phone:973-227-1820
Practice Address - Fax:973-227-1819
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI199821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice