Healthcare Provider Details

I. General information

NPI: 1609279843
Provider Name (Legal Business Name): CHERYL Y LEE, DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 QUINCY ST NE
WASHINGTON DC
20017-1738
US

IV. Provider business mailing address

1010 QUINCY ST NE
WASHINGTON DC
20017-1738
US

V. Phone/Fax

Practice location:
  • Phone: 202-832-5766
  • Fax:
Mailing address:
  • Phone: 202-832-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4370
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4370
License Number StateDC

VIII. Authorized Official

Name: DR. CHERYL Y LEE
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 202-832-5766