Provider Demographics
NPI:1841251196
Name:LEE, MYONG CHRISTINE (DDS)
Entity type:Individual
Prefix:DR
First Name:MYONG
Middle Name:CHRISTINE
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 1:165B BELLE FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2103
Mailing Address - Country:US
Mailing Address - Phone:615-662-2787
Mailing Address - Fax:
Practice Address - Street 1:165B BELLE FOREST CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2103
Practice Address - Country:US
Practice Address - Phone:615-662-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000004502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN62-1278738OtherTAX (EMPLOYER )ID NUMBER