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General NPI Number Information
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NPI Number | 1255913273
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Entity Type | Individual
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Provider Name | ALEX JINHYUK LEE DMD
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Gender | Male
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 1045 NORWOOD PARK BLVD STE 103
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City | AUSTIN
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State | TX
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Zip | 78753-6671
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Country | US
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Telephone | 512-815-3520
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Fax |
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Provider Business Mailing Address
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Address Line | 225 POOLE LN
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City | LIBERTY HILL
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State | TX
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Zip | 78642-2497
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Country | US
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Telephone | 872-772-5314
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 38296
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License Number State | TX
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