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General NPI Number Information
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NPI Number | 1346521200
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Entity Type | Individual
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Provider Name | JUNG HYUN LEE D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 280 N CENTRAL AVE STE 420
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City | HARTSDALE
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State | NY
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Zip | 10530-1842
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Country | US
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Telephone | 914-874-5121
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Fax | 914-874-5122
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Provider Business Mailing Address
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Address Line | 302 SAINT MICHAELS WALK
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City | UNION CITY
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State | NJ
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Zip | 07087-3367
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Country | US
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Telephone | 401-749-1545
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 057825
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License Number State | NY
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