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General NPI Number Information
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NPI Number | 1013549542
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Entity Type | Individual
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Provider Name | YUN JEONG LEE DMD
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Gender | Female
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 23206 LYONS AVE STE 203
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2672
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Country | US
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Telephone | 310-998-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 6260 W 3RD ST APT 112
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City | LOS ANGELES
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State | CA
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Zip | 90036-7602
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Country | US
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Telephone | 619-519-5937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS042485
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License Number State | PA
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