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General NPI Number Information
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NPI Number | 1598858094
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Entity Type | Individual
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Provider Name | JOSEPH LEE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 112 SW 160TH ST
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City | BURIEN
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State | WA
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Zip | 98166-3025
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Country | US
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Telephone | 206-244-6774
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Fax | 206-244-2204
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Provider Business Mailing Address
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Address Line | 112 SW 160TH ST
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City | BURIEN
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State | WA
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Zip | 98166-3025
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Country | US
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Telephone | 206-244-6774
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Fax | 206-244-2204
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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 | 22045
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE00009563
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License Number State | WA
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