Provider Demographics
NPI:1659182632
Name:JAMES JAEHYUNG LEE DENTAL COPORATION
Entity type:Organization
Organization Name:JAMES JAEHYUNG LEE DENTAL COPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JAEHYUNG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-499-9678
Mailing Address - Street 1:178 S VICTORIA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4368
Mailing Address - Country:US
Mailing Address - Phone:805-642-8165
Mailing Address - Fax:
Practice Address - Street 1:178 S VICTORIA AVE STE B
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4368
Practice Address - Country:US
Practice Address - Phone:805-642-8165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental