Healthcare Provider Details

I. General information

NPI: 1033051511
Provider Name (Legal Business Name): SEUNGBUM LEE, DMD, MSD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 S 324TH PL
FEDERAL WAY WA
98003-8505
US

IV. Provider business mailing address

1815 S 324TH PL
FEDERAL WAY WA
98003-8505
US

V. Phone/Fax

Practice location:
  • Phone: 253-838-3180
  • Fax:
Mailing address:
  • Phone: 253-838-3180
  • 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: DR. SEUNGBUM LEE
Title or Position: DENTIST
Credential: DMD, MSD
Phone: 253-838-3180