Provider Demographics
NPI:1881887420
Name:YUN S. LEE, D.D.S., INC.
Entity type:Organization
Organization Name:YUN S. LEE, D.D.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YUN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-251-0066
Mailing Address - Street 1:3550 WILSHIRE BLVD
Mailing Address - Street 2:835
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2401
Mailing Address - Country:US
Mailing Address - Phone:213-251-0066
Mailing Address - Fax:213-380-8228
Practice Address - Street 1:3550 WILSHIRE BLVD
Practice Address - Street 2:835
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2401
Practice Address - Country:US
Practice Address - Phone:213-251-0066
Practice Address - Fax:213-380-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53238261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental