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General NPI Number Information
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NPI Number | 1932549607
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Entity Type | Individual
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Provider Name | JOHN JAEWOO LEE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 5900 NORTH FWY STE 105
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City | HOUSTON
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State | TX
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Zip | 77076-4041
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Country | US
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Telephone | 281-771-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 GREEN KENSINGTON DR APT 1402
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City | HOUSTON
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State | TX
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Zip | 77008-1090
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Country | US
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Telephone | 972-786-6920
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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 | 29168
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License Number State | TX
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