Healthcare Provider Details

I. General information

NPI: 1891250429
Provider Name (Legal Business Name): DANIEL LEE, DDS, AND CHRISTINA LEE, DDS, MS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 2ND AVE SUITE 106
SEATTLE WA
98121-3065
US

IV. Provider business mailing address

820 BLANCHARD ST UNIT 1406
SEATTLE WA
98121-2655
US

V. Phone/Fax

Practice location:
  • Phone: 917-868-7381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA LEE
Title or Position: ORTHODONTIST
Credential: DDS, MS
Phone: 917-868-7381