Healthcare Provider Details

I. General information

NPI: 1760022511
Provider Name (Legal Business Name): SUNG Y. LEE DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23750 CRENSHAW BLVD
TORRANCE CA
90505-5220
US

IV. Provider business mailing address

23750 CRENSHAW BLVD
TORRANCE CA
90505-5220
US

V. Phone/Fax

Practice location:
  • Phone: 310-787-1233
  • Fax: 310-787-1239
Mailing address:
  • Phone: 310-787-1233
  • Fax: 310-787-1239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. SUNG YOUNG LEE
Title or Position: CEO
Credential: DMD
Phone: 714-722-1222