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General NPI Number Information
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NPI Number | 1720714454
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Entity Type | Individual
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Provider Name | SUNNY JISUN LEE DDS
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Gender | Female
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 1704 MIRAMONTE AVE STE 9
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-3718
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Country | US
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Telephone | 650-282-5758
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Fax |
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Provider Business Mailing Address
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Address Line | 150 MARKET ST. 428
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City | MILPITAS
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State | CA
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Zip | 95035
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Country | US
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Telephone | 310-944-1635
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 109995
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License Number State | CA
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