Healthcare Provider Details

I. General information

NPI: 1871458414
Provider Name (Legal Business Name): SUNG Y. LEE DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 W CARSON ST STE E
TORRANCE CA
90501-2828
US

IV. Provider business mailing address

1757 W CARSON ST STE E
TORRANCE CA
90501-2828
US

V. Phone/Fax

Practice location:
  • Phone: 714-722-1222
  • Fax:
Mailing address:
  • Phone: 714-722-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUNG Y LEE
Title or Position: CEO
Credential: DMD
Phone: 714-722-1222