Provider Demographics
NPI:1255561908
Name:LEE, HANNAH H (DDS)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:H
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 1:4812 TREASURE CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2374
Mailing Address - Country:US
Mailing Address - Phone:716-957-2848
Mailing Address - Fax:
Practice Address - Street 1:4812 TREASURE CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-2374
Practice Address - Country:US
Practice Address - Phone:716-957-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412543122300000X
DCDEN100023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist