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General NPI Number Information
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NPI Number | 1336532712
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Entity Type | Individual
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Provider Name | SOONJAE LEE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 225 WILMINGTON W CHESTER PIKE STE 202
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City | CHADDS FORD
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State | PA
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Zip | 19317-9011
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Country | US
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Telephone | 267-270-5658
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Fax |
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Provider Business Mailing Address
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Address Line | 225 WILMINGTON W CHESTER PIKE STE 202
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City | CHADDS FORD
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State | PA
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Zip | 19317-9011
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Country | US
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Telephone | 267-270-5658
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | DS040281
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 22DI02659400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | G1-0001439
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License Number State | DE
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