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NPI Code Detail

MEDICARE: DR. JOHNNY S LEE DDS

MEDICARE: DR. JOHNNY S LEE DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6866WA

General Provider Information

NPI Number : 1134343163
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHNNY S LEE DDS
Provider Business Mailing Address
First Line : 15013 AURORA AVE N
Second Line :
City : SHORELINE
State : WA
Zip : 98133-6134
Country : US
Telephone Number : 206-364-7737
Fax Number : 206-364-8011
Provider Business Practice Location Address
First Line : 15013 AURORA AVE N
Second Line :
City : SHORELINE
State : WA
Zip : 98133-6134
Country : US
Telephone Number : 206-364-7737
Fax Number : 206-364-8011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JOHNNY S LEE DDS” Practice Location

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