Provider Demographics
NPI:1740336163
Name:LEE, CHINHA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHINHA
Middle Name:
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 1:19251 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:SUITE F20
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886
Mailing Address - Country:US
Mailing Address - Phone:301-977-0126
Mailing Address - Fax:301-977-8062
Practice Address - Street 1:19251 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:SUITE F20
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886
Practice Address - Country:US
Practice Address - Phone:301-977-0126
Practice Address - Fax:301-977-8067
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist