Healthcare Provider Details

I. General information

NPI: 1821924614
Provider Name (Legal Business Name): SANDRA SUNWOO LEE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N STONEWALL AVE
OKLAHOMA CITY OK
73117-1214
US

IV. Provider business mailing address

1916 BROOKE CT
EDMOND OK
73003-9012
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-7744
  • Fax:
Mailing address:
  • Phone: 405-513-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8205
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: