Healthcare Provider Details

I. General information

NPI: 1720557556
Provider Name (Legal Business Name): YOONA LEE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 CANYON BLVD
BOULDER CO
80302-5407
US

IV. Provider business mailing address

15026 SILVER FEATHER CIR
BROOMFIELD CO
80023-4609
US

V. Phone/Fax

Practice location:
  • Phone: 303-442-5000
  • Fax:
Mailing address:
  • Phone: 720-456-2850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00203774
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: