Provider Demographics
NPI:1831762590
Name:LEE, YOOJIN (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:YOOJIN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:DR
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MDS
Mailing Address - Street 1:333 SCHERMERHORN ST APT 15S
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4423
Mailing Address - Country:US
Mailing Address - Phone:917-453-9533
Mailing Address - Fax:
Practice Address - Street 1:530 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4809
Practice Address - Country:US
Practice Address - Phone:646-893-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0617691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics