Provider Demographics
NPI:1982750055
Name:KYUNG-LEE, YUN DOK (DMD)
Entity Type:Individual
Prefix:
First Name:YUN
Middle Name:DOK
Last Name:KYUNG-LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:YUN
Other - Middle Name:DOK
Other - Last Name:KYUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2518 NW PINNACLE DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-8000
Mailing Address - Country:US
Mailing Address - Phone:503-407-5872
Mailing Address - Fax:
Practice Address - Street 1:1933 SW JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-2405
Practice Address - Country:US
Practice Address - Phone:503-273-8240
Practice Address - Fax:503-228-4944
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD71741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice