Provider Demographics
NPI:1750381216
Name:LEE, HYUN MIN (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:HYUN
Middle Name:MIN
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10029 SW NIMBUS AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7110
Mailing Address - Country:US
Mailing Address - Phone:503-596-0500
Mailing Address - Fax:503-596-0502
Practice Address - Street 1:10029 SW NIMBUS AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7110
Practice Address - Country:US
Practice Address - Phone:503-596-0500
Practice Address - Fax:503-596-0502
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2008-01-30
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
ORD79911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice