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General NPI Number Information
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NPI Number | 1568782183
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Entity Type | Individual
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Provider Name | SHUYA LEE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 6325 TOPANGA CANYON BLVD SUITE 320
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2006
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Country | US
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Telephone | 818-716-7966
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Fax |
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Provider Business Mailing Address
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Address Line | 3628 DIXIE CANYON PL
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-4841
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Country | US
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Telephone | 818-454-9134
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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 | 49926
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License Number State | CA
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