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General NPI Number Information
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NPI Number | 1972291813
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Entity Type | Individual
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Provider Name | HYUN JEE LEE DDS
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Gender | Female
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Dates
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Enumeration Date | 04/28/2023
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 3601 E 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90063-2325
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Country | US
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Telephone | 323-268-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 2 BRIARGLEN
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City | IRVINE
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State | CA
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Zip | 92614-7598
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Country | US
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Telephone | 949-923-7458
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 110662
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License Number State | CA
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